Active NPI
Peter C. Hanley, MD
- Cardiovascular Disease Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 01038244A
- Practice address
- 7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140 - Phone
- (260) 432-2297
- Fax
- (260) 434-6433
- NPI assigned
- Jan 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | 01038244A | IN | |
| Nuclear Cardiology Physician | 207UN0901X | 01038244A | IN | |
| Cardiovascular Disease Physician | 207RC0000X | 01038244A | IN | Primary |
Addresses
Primary practice location
7916 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Mailing address
6920 Pointe Inverness Way Ste 200
Medpartners, Attn: Barb Copeland
Fort Wayne, IN 46804-7934
Phone (260) 479-3514
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00783720 | Other | IN | RAILROAD |
| 260690NNN | Other | IN | MEDICARE |
| 0781695 | Medicaid | OH | |
| 000000087426 | Other | IN | ANTHEM |
| 100262190 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | peter.hanley@lutheranhealthnetwork.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1205 Provident Dr
Suite a
Warsaw, IN 46580-3265
Phone (574) 269-8383
2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076
7910 W Jefferson Blvd
Fort Wayne, IN 46804-4159
Hospital & facility affiliations
- Kosciusko Community Hospital
- Lutheran Hospital of Indiana
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.99 of 100
- Quality
- 77.41
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038244A | IN | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Fort Wayne, IN
- NPI 1164662805
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1306897335
-
- General Acute Care Hospital
- Warsaw, IN
- NPI 1164475711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1346220993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6920 POINTE INVERNESS WAY STE 200",
"address_2": "MEDPARTNERS, ATTN: BARB COPELAND",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047934",
"telephone_number": "260-479-3514",
"fax_number": "260-479-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7916 W JEFFERSON BLVD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044140",
"telephone_number": "260-432-2297",
"fax_number": "260-434-6433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANLEY",
"first_name": "PETER",
"middle_name": "C.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "IN",
"license": "01038244A",
"primary": false
},
{
"code": "207UN0901X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Cardiology",
"state": "IN",
"license": "01038244A",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IN",
"license": "01038244A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00783720",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "260690NNN",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0781695",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000087426",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100262190",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "peter.hanley@lutheranhealthnetwork.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "AMR direct address",
"address_1": "7916 W Jefferson Blvd",
"city": "Fort Wayne",
"state": "IN",
"country_code": "US",
"postal_code": "468044140",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.