Individual provider Active NPI

Dennis James Hanson, O.D.

  • Optometrist
  • Auburn, CA
National Provider Identifier
1467542522
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5685T Issued in CA
Practice address
342 Elm Ave.
Auburn, CA 95603
Phone
(530) 885-2023
Fax
(530) 885-5281
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5685T CA Primary

Addresses

Primary practice location

342 Elm Ave.
Auburn, CA 95603

Mailing address

342 Elm Ave
Auburn, CA 95603
Phone (530) 885-2023

Other identifiers 1

IdentifierTypeStateIssuer
3384538MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090109000173 CA Practitioner - Optometry 4082777578 Practice locations: Auburn, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5685TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1467542522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 ELM AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "95603",
            "telephone_number": "530-885-2023",
            "fax_number": "530-885-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 ELM AVE.",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "95603",
            "telephone_number": "530-885-2023",
            "fax_number": "530-885-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "DENNIS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5685T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3384538",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.