Individual provider Active NPI

Samson H Hanka, M.D.

  • Internal Medicine Physician
  • Millbury, MA
National Provider Identifier
1447561204
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
254100 Issued in MA
Practice address
65 Canal St
Millbury, MA 01527-3266
Phone
(508) 865-9960
Fax
(508) 865-3399
NPI assigned
Jun 27, 2010
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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 254100 MA Primary

Addresses

Primary practice location

65 Canal St
Millbury, MA 01527-3266

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (700) 225-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130814000252 MA Practitioner - Internal Medicine 8820230279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

65 Canal St
Millbury, MA 01527-3266
Phone (508) 865-9960

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254100MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Physician Services, Inc. Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince Aug 21, 2021 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Aug 21, 2021 Accepting new patients
Atrius Health, Inc. Internal Medicine PastSince Aug 19, 2013 Accepting new patients

Locations

40 Wright St
Palmer, MA 01069
Phone (413) 284-5210

102 Shore Dr
Ste 303
Worcester, MA 01605
Phone (508) 856-0458

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1277596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1447561204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "700-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CANAL ST",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015273266",
            "telephone_number": "508-865-9960",
            "fax_number": "508-865-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKA",
        "first_name": "SAMSON",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "254100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbury, MA

Sources for this page

Verify at the official NPI Registry.