Active NPI
Charlene Hansen, M.D.
- Internal Medicine Physician
- Sacramento, CA
National Provider Identifier
1366556748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 168946
- Practice address
- 1500 21St St
Sacramento, CA 95811-5216 - Phone
- (916) 443-3299
- NPI assigned
- Aug 19, 2006
- Last updated
- Mar 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 31508 | IA | |
| Internal Medicine Physician | 207R00000X | 168946 | CA | Primary |
Addresses
Primary practice location
1500 21St St
Sacramento, CA 95811-5216
Mailing address
1500 21St St
Sacramento, CA 95811-5216
Phone (916) 443-3299
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 417198 | Medicaid | AZ | |
| 000R7592 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 168946 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo Pintado Clinic | Current | Accepting new patients | |
| DHHS PHS Naihs Crownpoint Hospital | Current | Accepting new patients | |
| American Current Care P.a. | Current | Accepting new patients | |
| Thoreau Clinic | Current | Accepting new patients | |
| American Current Care, P.a. | Current | Accepting new patients |
Locations
720 Saint Michaels Dr
Ste D
Santa Fe, NM 87505
Phone (505) 438-9402
5080 Spectrum Dr
Ste 1200W
Addison, TX 75001
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Concentra Urgent Care
- Health Service Clinic/Center
- Addison, TX
- NPI 1730360124
NM
-
dba Concentra Urgent Care
- Urgent Care Clinic/Center
- Beaumont, TX
- NPI 1376356568
-
- Clinic/Center
- Cuba, NM
- NPI 1023051133
-
- Clinic/Center
- Thoreau, NM
- NPI 1679516702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648166400000",
"number": "1366556748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 21ST ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958115216",
"telephone_number": "916-443-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 21ST ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958115216",
"telephone_number": "916-443-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "CHARLENE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2022-03-25",
"certification_date": "2022-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IA",
"license": "31508",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "168946",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "417198",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000R7592",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.