Individual provider Active NPI

Gamal K Hanna, MD

  • Emergency Medicine Physician
  • Jersey City, NJ
National Provider Identifier
1467444968
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA05217700 Issued in NJ
Practice address
79 Nelson Ave
Jersey City, NJ 07307-4006
Phone
(201) 653-3880
NPI assigned
Aug 19, 2005
Last updated
Nov 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA05217700 NJ Primary

Addresses

Primary practice location

79 Nelson Ave
Jersey City, NJ 07307-4006

Mailing address

79 Nelson Ave
Jersey City, NJ 07307
Phone (201) 653-3880

Other identifiers 1

IdentifierTypeStateIssuer
1884808MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20041222000300 NJ Practitioner - Emergency MedicinePractitioner - Internal Medicine 9234197245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stadium Emergency AssociatesGroup PAC ID 6406150010, 24 clinicians

Practice addresses (Care Compare)

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stadium Emergency Associates CurrentSince Feb 1, 2019 Accepting new patients
Bergen County Improvement Authority CurrentSince Jul 10, 2012 Accepting new patients
Bergen County Improvement Authority CurrentSince Jul 10, 2012 Accepting new patients
Jersey City Medical Center Emergency Medicine Past Accepting new patients
Emergency Associates of the North Ward, P.a. Emergency Medicine Past Accepting new patients

Locations

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

66 W Gilbert St
#2N
Tinton Falls, NJ 07701

66 W Gilbert St
Fl 2
Tinton Falls, NJ 07701
Phone (732) 212-0051

Organizations & group practices 6

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 1

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1467444968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 NELSON AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07307",
            "telephone_number": "201-653-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 NELSON AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073074006",
            "telephone_number": "201-653-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "GAMAL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA05217700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1884808",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.