Ellen M Hanisch, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP60134362 Issued in WA

Practice address

11511 Canterwood Blvd
Suite 45
Gig Harbor, WA 98332-5813

Phone

(253) 858-4725

Fax

(253) 858-4452

NPI assigned

Jul 9, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Ms. Ellen M. Hagemeier Other name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwest Medical Specialties PLLCGroup PAC ID 8022903384, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
• St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
• St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Northwest Medical Specialties PLLC

  • Multi-Specialty Clinic/Center
  • Tacoma, WA
  • NPI 1548261308
  Medicare reassignment Care Compare group NPD
• Northwest Medical Specialties Pharmacy

  • Clinic Pharmacy
  • Tacoma, WA
  • NPI 1053489062
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Washington Community Care

  • General Acute Care Hospital
  • Silverdale, WA
  • NPI 1518912609
  Care Compare affiliation
• Franciscan Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1124291117
  Care Compare affiliation
• Franciscan Health System

  • General Acute Care Hospital
  • Gig Harbor, WA
  • NPI 1447406699
  Care Compare affiliation
• Franciscan Health System

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1659585370

  Hospital

  Care Compare affiliation
• Franciscan Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1952309098
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1346248754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 SOUTH I STREET",
            "address_2": "SUITE 305",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055093",
            "telephone_number": "253-428-8700",
            "fax_number": "253-383-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD",
            "address_2": "SUITE 45",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-858-4725",
            "fax_number": "253-858-4452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANISCH",
        "first_name": "ELLEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-09",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A-108210",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "110748",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60134362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "33314",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0421586",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "HAGEMEIER",
            "middle_name": "M.",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Nurse Practitioner in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.

Verify at the official NPI Registry.