Individual provider Active NPI

James Jon Hanusa, M.D.

  • Internal Medicine Physician
  • Bradenton, FL
National Provider Identifier
1417923855
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 94858 Issued in FL
Practice address
2902 59TH St W
Suite M
Bradenton, FL 34209-7023
Phone
(941) 795-7401
Fax
(941) 795-7414
NPI assigned
Feb 26, 2006
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 94858 FL Primary

Addresses

Primary practice location

2902 59TH St W
Suite M
Bradenton, FL 34209-7023

Mailing address

2902 59TH St W
Suite M
Bradenton, FL 34209-7023
Phone (941) 795-7401

Other identifiers 1

IdentifierTypeStateIssuer
275276000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060707000166 FL Practitioner - Internal Medicine 0547272700 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 94858FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Medical Care, Inc CurrentSince Mar 23, 2024 Accepting new patients

Locations

2225 59th St W
Ste B
Bradenton, FL 34209
Phone (941) 761-1746

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABIACD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1417923855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 59TH ST W",
            "address_2": "SUITE M",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097023",
            "telephone_number": "941-795-7401",
            "fax_number": "941-795-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 59TH ST W",
            "address_2": "SUITE M",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097023",
            "telephone_number": "941-795-7401",
            "fax_number": "941-795-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANUSA",
        "first_name": "JAMES",
        "middle_name": "JON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-26",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 94858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275276000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.