Individual provider Active NPI

Dale Eugene Hansen III, M.D.

  • Vascular & Interventional Radiology Physician
  • Memphis, TN
National Provider Identifier
1417182007
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
48831 Issued in TN
Practice address
7695 Poplar Pike
Suite 101
Memphis, TN 38138-5947
Phone
(901) 685-2696
Fax
(901) 682-9747
NPI assigned
May 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 48831 TN Primary
Vascular & Interventional Radiology Physician 2085R0204X 23506 MS
Diagnostic Radiology Physician 2085R0202X MD0000048831 TN

Addresses

Primary practice location

7695 Poplar Pike
Suite 101
Memphis, TN 38138-5947

Mailing address

7695 Poplar Pike
Suite 101
Memphis, TN 38138-5947
Phone (901) 685-2696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150501001475 MS Practitioner - Diagnostic Radiology 0547409690 Reassigns benefits to 1 organization
I20150529001258 TN Practitioner - Diagnostic Radiology 0547409690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memphis Radiological PCGroup PAC ID 1557333226, 50 clinicians

Practice addresses (Care Compare)

103 Halls CV
Senatobia, MS 38668-6620
Phone (662) 562-9003

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 516-7600

1300 Wesley Dr
Memphis, TN 38116-6426
Phone (901) 516-3700

1377 S Germantown Rd
Germantown, TN 38138-2225
Phone (901) 759-7500

1801 Union Ave
Memphis, TN 38104-3942
Phone (901) 722-3130

3960 New Covington Pike
Memphis, TN 38128-2504
Phone (901) 516-5200

4250 Bethel Rd
Olive Branch, MS 38654-8737
Phone (662) 932-9000

551 Azalea Dr
Oxford, MS 38655-7900
Phone (662) 234-0332

6401 Poplar Ave
Suite 100
Memphis, TN 38119-4840
Phone (901) 387-2340

705 N State St
Clarksdale, MS 38614-6519
Phone (662) 627-2973

7400 Airways Blvd
Southaven, MS 38671-5863
Phone (662) 536-1000

7691 Poplar Ave
Memphis, TN 38138-3904
Phone (901) 561-6000

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 725-5100

935 Wayne Rd
Savannah, TN 38372-1904
Phone (731) 926-8000

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167
  • Hardin Medical Center Hospital, Savannah, TN, CCN 440109

Merit-based Incentive Payment System (MIPS)

Final score
88.97 of 100Reported as group
Quality
92.01
Improvement activities
40
Cost
77.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal40
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48831TNMDPharmacist
MD0000048831TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Radiological, P.C. Diagnostic Radiology CurrentSince Jul 1, 2015 Accepting new patients
Memphis Radiological, P.C. Diagnostic Radiology CurrentSince Jul 1, 2015 Accepting new patients
Memphis Radiological, PC Past Accepting new patients

Locations

551 Medical Dr
Clarksdale, MS 38614
Phone (662) 624-2531

1938 Crescent Meadows Dr
Holly Springs, MS 38635
Phone (662) 252-1599

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

103 Halls Cv
Senatobia, MS 38668
Phone (662) 562-9003

3674 Goodman Rd E
#E
Southaven, MS 38672

7400 Airways Blvd
Southaven, MS 38671
Phone (662) 536-1000

1377 S Germantown Rd
Germantown, TN 38138
Phone (901) 516-6792

7800 Wolf Trail Cv
Germantown, TN 38138
Phone (901) 682-9222

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

1801 Union Ave
Memphis, TN 38104
Phone (901) 516-6792

7695 Poplar Pike
Ste 101
Memphis, TN 38138

6401 Poplar Ave
Ste 505
Memphis, TN 38119
Phone (901) 683-1890

3950 New Covington Pike
Memphis, TN 38128
Phone (901) 387-2900

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1803 Union Ave
Ste 2
Memphis, TN 38104
Phone (901) 722-3136

225 S Claybrook St
Memphis, TN 38104
Phone (901) 516-2152

7710 Wolf River Cir
Memphis, TN 38138
Phone (901) 685-5969

8071 Winchester Rd
Memphis, TN 38125
Phone (901) 367-9001

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

6401 Poplar Ave
Ste 100
Memphis, TN 38119
Phone (901) 387-2340

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

76 Tabb Dr
Ste E
Munford, TN 38058
Phone (901) 840-2102

935 Wayne Rd
Savannah, TN 38372
Phone (731) 925-4954

Interoperability endpoints

  • Direct secure messaging: dhansen36885@mlh.direct-ci.com

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.

Hospital & facility affiliations 5

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": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1417182007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7695 POPLAR PIKE",
            "address_2": "SUITE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381385947",
            "telephone_number": "901-685-2696",
            "fax_number": "901-682-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7695 POPLAR PIKE",
            "address_2": "SUITE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381385947",
            "telephone_number": "901-685-2696",
            "fax_number": "901-682-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "DALE",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "48831",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MS",
            "license": "23506",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD0000048831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.