Individual provider Active NPI

Kathleen Hanover, M.D.

  • Dermatology Physician
  • Fishers, IN
National Provider Identifier
1437504453
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
01084044A Issued in IN
Practice address
11580 Overlook Dr Ste 300
Fishers, IN 46037-4221
Phone
(317) 926-3739
NPI assigned
Apr 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 01084044A IN Primary
Dermatology Physician 207N00000X 11019171A IN

Addresses

Primary practice location

11580 Overlook Dr Ste 300
Fishers, IN 46037-4221

Mailing address

875 Airport Pkwy
Greenwood, IN 46143-1085
Phone (317) 926-3739

Other practice location 1

725 Lakefront Ct
Carmel, IN 46032-5893
Phone (317) 926-3739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20200630003039 IN Practitioner - Dermatology 0244522647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Inc.Group PAC ID 4587604962, 20 clinicians

Practice addresses (Care Compare)

725 Lakefront CT
Carmel, IN 46032-5893
Phone (317) 926-3739

875 Airport Pkwy
Greenwood, IN 46143-1085
Phone (317) 926-3739

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision25
Removal of skin lesions714
Removal or shaving of skin growth1-10
Skin biopsy275

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Inc Dermatology CurrentSince Aug 20, 2020 Accepting new patients
Dermatology Inc Dermatology CurrentSince Aug 20, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

725 Lakefront Ct
Carmel, IN 46032
Phone (317) 426-3739

11580 Overlook Dr
Ste 300
Fishers, IN 46037
Phone (317) 567-5200

875 Airport Pkwy
Greenwood, IN 46143
Phone 31792637395155

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.

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1437504453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 AIRPORT PKWY",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431085",
            "telephone_number": "317-926-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11580 OVERLOOK DR STE 300",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374221",
            "telephone_number": "317-926-3739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Lakefront Ct",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460325893",
            "country_code": "US",
            "telephone_number": "317-926-3739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANOVER",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01084044A",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "11019171A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.