Active NPI
Dwayne M Hansen, M.D.
- Surgery Physician
- Rexburg, ID
National Provider Identifier
1376581546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- M8427
- Practice address
- 381 East 4TH North
Ste 100
Rexburg, ID 83440 - Phone
- (208) 656-8442
- Fax
- (208) 656-8453
- NPI assigned
- Jun 2, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | M8427 | ID | Primary |
Addresses
Primary practice location
381 East 4TH North
Ste 100
Rexburg, ID 83440
Mailing address
PO Box 185
Rexburg, ID 83440-0185
Phone (208) 656-8442
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48488 | Other | ID | BLUE CROSS OF IDAHO |
| CS9440 | Other | ID | IDAHO STATE BOARD OF PHAR |
| M8427 | Other | ID | IDAHO STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- 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
- General Surgery
- Education
- Tulane University School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
381 E 4TH
Suite 100
Rexburg, ID 83440-1684
Phone (208) 656-8442
Hospital & facility affiliations
- Madison Memorial Hospital
- Mountain View Hospital
- Teton Valley Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 44 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 25 |
| Varicose vein removal | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M8427 | ID | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dwayne M. Hansen MD PLLC | Surgery | Current | Accepting new patients |
| Max Hansen Surgery PLLC | Surgery | Past | Accepting new patients |
| Rexburg Surgery Center LLC | Past | Accepting new patients |
Locations
381 E 4th N
#100
Rexburg, ID 83440
Phone (208) 359-1888
Organizations & group practices 3
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.
-
- Surgery Physician
- Rexburg, ID
- NPI 1114024650
-
- Ambulatory Surgical Clinic/Center
- Rexburg, ID
- NPI 1831134584
-
- Surgery Physician
- Rexburg, ID
- NPI 1497403760
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rexburg, ID
- NPI 1992747570
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1669462362
-
- Critical Access Hospital
- Driggs, ID
- NPI 1477809622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1376581546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 185",
"city": "REXBURG",
"state": "ID",
"postal_code": "834400185",
"telephone_number": "208-656-8442",
"fax_number": "208-656-8453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "381 EAST 4TH NORTH",
"address_2": "STE 100",
"city": "REXBURG",
"state": "ID",
"postal_code": "83440",
"telephone_number": "208-656-8442",
"fax_number": "208-656-8453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "DWAYNE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ID",
"license": "M8427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "48488",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO STATE BOARD OF PHAR",
"identifier": "CS9440",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO STATE LICENSE",
"identifier": "M8427",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.