Individual provider Active NPI

Daniel Allan Hamstra, MD PHD

  • Radiation Oncology Physician
  • Dearborn, MI
National Provider Identifier
1386656213
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4301077751 Issued in MI
Practice address
18181 Oakwood Blvd
Dearborn, MI 48124-5032
Phone
(313) 593-3733
Fax
(248) 982-5425
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 4301077751 MI Primary
Radiation Oncology Physician 2085R0001X Q4421 TX

Addresses

Primary practice location

18181 Oakwood Blvd
Dearborn, MI 48124-5032

Mailing address

130 Town Center Dr
Suite 203
Troy, MI 48084-1744
Phone (248) 585-8265

Other identifiers 3

IdentifierTypeStateIssuer
346767201MedicaidTX
P01667433OtherTXRAILROAD
346767202MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dhamstra449513@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150630000538 TX Practitioner - Radiation Oncology 0143225888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Michigan Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1919 Old Spanish TRL
Houston, TX 77054-2003

2 Greenway PLZ
Suite 900
Houston, TX 77046-0205

7200 Cambridge St
Houston, TX 77030-4202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4301077751MIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Mar 1, 2021 Accepting new patients
Baylor College of Medicine CurrentSince Mar 1, 2021 Accepting new patients
Baylor College of Medicine CurrentSince Mar 1, 2021 Accepting new patients
Baylor College of Medicine CurrentSince Mar 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1919 Old Spanish Trl
Fl 1
Houston, TX 77054
Phone (713) 798-4321

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1386656213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR",
            "address_2": "SUITE 203",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8265",
            "fax_number": "248-585-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-593-3733",
            "fax_number": "248-982-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMSTRA",
        "first_name": "DANIEL",
        "middle_name": "ALLAN",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301077751",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "Q4421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346767201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01667433",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346767202",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhamstra449513@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "18181 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481245032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.