NPIMap

Individual provider Active NPI

Mark T Hansberry

  • Diagnostic Radiology Physician
  • Lebanon, NH
National Provider Identifier
1417993262
Registry record updated Dec 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11277 Issued in NH
Practice address
One Medical Center Drive
Dartmouth Hitchcock - Radiology
Lebanon, NH 03756
Phone
(603) 650-7650
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 042.0010258 VT
Diagnostic Radiology Physician 2085R0202X 11277 NH Primary

Addresses

Primary practice location

One Medical Center Drive
Dartmouth Hitchcock - Radiology
Lebanon, NH 03756

Mailing address

One Medical Center Drive
Dartmouth Hitchcock - Radiology
Lebanon, NH 03756
Phone (603) 650-7650

Other practice location 1

243 Elm St
Valley Regional Hospital
Claremont, NH 03743-2005
Phone (603) 542-7771

Other identifiers 1

IdentifierTypeStateIssuer
1008034MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060214000655 NH Practitioner - Diagnostic Radiology 6002821923 Reassigns benefits to 5 organizations
I20110920000196 VT Practitioner - Diagnostic Radiology 6002821923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-6711

Hospital & facility affiliations

  • New London Hospital Hospital, New London, NH, CCN 301304
  • Mt Ascutney Hospital Hospital, Windsor, VT, CCN 471302
  • Valley Regional Hospital Hospital, Claremont, NH, CCN 301308
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003
  • Alice Peck Day Memorial Hospital Hospital, Lebanon, NH, CCN 301305

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042.0010258VTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Peck Day Memorial Hospital Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Dec 18, 2017 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Dec 18, 2017 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Aug 1, 2025 Accepting new patients
The New London Hospital Association, Inc. CurrentSince Jan 28, 2024 Accepting new patients
Alice Peck Day Memorial Hospital CurrentSince Aug 1, 2025 Accepting new patients
Dartmouth-Hitchcock Clinic Diagnostic Radiology CurrentSince Dec 18, 2017 Accepting new patients
The New London Hospital Association, Inc. CurrentSince Jan 28, 2024 Accepting new patients
The New London Hospital Association, Inc. Past Accepting new patients
Brattleboro Memorial Hospital PastSince Aug 1, 2016 Accepting new patients

Locations

243 Elm St
Claremont, NH 03743
Phone (603) 542-7771

173 Middle St
Lancaster, NH 03584
Phone (603) 788-4911

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

10 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-7440

5 Alice Peck Day Dr
Lebanon, NH 03766
Phone (603) 448-3996

273 County Rd
New London, NH 03257
Phone (603) 526-5215

53 Fairview St
Brattleboro, VT 05301
Phone (802) 251-8455

289 County Rd
Windsor, VT 05089
Phone (802) 674-7220

Interoperability endpoints

  • FHIR API: https://edhwebportal.hitchcock.org/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/
  • Direct secure messaging: mhansberry305465@direct.dartmouth-hitchcock.org

Organizations & group practices 10

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1417993262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "address_2": "DARTMOUTH HITCHCOCK - RADIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03756",
            "telephone_number": "603-650-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER DRIVE",
            "address_2": "DARTMOUTH HITCHCOCK - RADIOLOGY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "03756",
            "telephone_number": "603-650-7650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "243 Elm St",
            "address_2": "Valley Regional Hospital",
            "address_purpose": "LOCATION",
            "city": "Claremont",
            "state": "NH",
            "postal_code": "037432005",
            "country_code": "US",
            "telephone_number": "603-542-7771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSBERRY",
        "first_name": "MARK",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VT",
            "license": "042.0010258",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "11277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008034",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.