Individual provider Active NPI

Robert Hannon, MD

  • Diagnostic Radiology Physician
  • Methuen, MA
National Provider Identifier
1467447730
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
37890 Issued in MA
Practice address
70 East St
Methuen, MA 01844-4597
Phone
(978) 682-3004
NPI assigned
Sep 13, 2005
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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 5544 NH
Diagnostic Radiology Physician 2085R0202X 37890 MA Primary

Addresses

Primary practice location

70 East St
Methuen, MA 01844-4597

Mailing address

PO Box 9135
Att: Sharon Silva
Brookline, MA 02446-9135
Phone (800) 927-0002

Other identifiers 2

IdentifierTypeStateIssuer
81303244MedicaidNH
2032589MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050715000424 MA Practitioner - Diagnostic Radiology 5092798009 Reassigns benefits to 1 organization
I20051022000005 NH Practitioner - Diagnostic Radiology 5092798009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Vermont College of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Merrimack Valley Pet PCGroup PAC ID 7810945888, 2 clinicians

Practice addresses (Care Compare)

23 Stiles Rd
Salem, NH 03079-2859
Phone (603) 893-4352

70 E St
Methuen, MA 01844-4597
Phone (978) 689-4738

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5544NHMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Xray Diagnostics LLC CurrentSince Dec 28, 2020 Accepting new patients
Merrimack Valley Pet PC CurrentSince May 11, 2007 Accepting new patients
Northern Radiology Associates Diagnostic Radiology PastSince Jun 1, 1975 Accepting new patients

Locations

35 New England Business Center Dr
Ste 103
Andover, MA 01810

354 Merrimack St
Lawrence, MA 01843
Phone (978) 688-3898

354 Merrimack St
Ste 1
Lawrence, MA 01843

70 East St
Methuen, MA 01844
Phone (978) 682-1906

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 2

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1467447730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9135",
            "address_2": "ATT: SHARON SILVA",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024469135",
            "telephone_number": "800-927-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 EAST ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444597",
            "telephone_number": "978-682-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "5544",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "37890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81303244",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2032589",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

Verify at the official NPI Registry.