Individual provider Active NPI

Sahar Gamal Hanna, MD

  • Pediatrics Physician
  • Crown Point, IN
National Provider Identifier
1467693580
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
52268 Issued in MN
Practice address
9470 Broadway
Crown Point, IN 46307-5722
Phone
(219) 661-3260
Fax
(219) 662-3770
NPI assigned
Mar 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 52268 MN Primary
Personal Emergency Response Attendant 146D00000X 249680-1 NY
Pediatrics Physician 208000000X 13035-320 WI

Addresses

Primary practice location

9470 Broadway
Crown Point, IN 46307-5722

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

480 Osborne Rd NE
Fridley, MN 55432-2773
Phone (763) 785-4500

Other practice location 2

707 14th St
Baraboo, WI 53913-1539
Phone (608) 356-1400

Other identifiers 1

IdentifierTypeStateIssuer
1467693580MedicaidWI

Other names 1

  • Sahar Gamal Khalil Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address shanna530899@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MN, IN, WI4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20090422000590 NY Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1355498742 Reassigns benefits to 2 organizations
I20091203000058 MN Practitioner - Pediatric Medicine 1355498742 Reassigns benefits to 2 organizations
I20180131001205 IN Practitioner - Pediatric Medicine 1355498742 Reassigns benefits to 1 organization
I20250303001454 WI Practitioner - Pediatric Medicine 1355498742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

707 14TH St
Baraboo, WI 53913-1539
Phone (608) 356-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
249680-1NYMDPersonal Emergency Response Attendant
13035-320WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Feb 17, 2025 Accepting new patients
Dean Health Systems, Inc. CurrentSince Feb 17, 2025 Accepting new patients
Auburn Memorial Medical Services, PC CurrentSince Mar 25, 2025 Accepting new patients
Auburn Community Hospital CurrentSince Mar 25, 2025 Accepting new patients
Avera Marshall Current Accepting new patients
Auburn Community Hospital CurrentSince Mar 25, 2025 Accepting new patients
Auburn Memorial Medical Services, PC Pediatrics CurrentSince Mar 25, 2025 Accepting new patients
Northshore Health Centers, Inc. Pediatrics CurrentSince Nov 29, 2021 Accepting new patients
Northshore Health Centers Inc Current Accepting new patients
Northshore Health Centers, Inc. CurrentSince Nov 29, 2021 Accepting new patients
Avera Marshall CurrentSince Jan 11, 2021 Accepting new patients

Locations

6050 Sterling Creek Rd
Portage, IN 46368
Phone (219) 212-0188

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

77 Nelson St
Ste 120
Auburn, NY 13021
Phone (315) 252-7550

37 W Garden St
Ste 105
Auburn, NY 13021
Phone (315) 252-0000

17 Lansing St
Sennett, NY 13021
Phone (315) 255-7011

707 14th St
Baraboo, WI 53913
Phone (608) 356-1400

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: sahar.hanna.p1@direct.northshorehealth.nextgenshare.com
  • Direct secure messaging: drhanna@amms.medentdirect.com

Organizations & group practices 11

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": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1467693580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463075722",
            "telephone_number": "219-661-3260",
            "fax_number": "219-662-3770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Osborne Rd NE",
            "address_purpose": "LOCATION",
            "city": "Fridley",
            "state": "MN",
            "postal_code": "554322773",
            "country_code": "US",
            "telephone_number": "763-785-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "707 14th St",
            "address_purpose": "LOCATION",
            "city": "Baraboo",
            "state": "WI",
            "postal_code": "539131539",
            "country_code": "US",
            "telephone_number": "608-356-1400",
            "fax_number": "608-356-1367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNA",
        "first_name": "SAHAR",
        "middle_name": "GAMAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "52268",
            "primary": true
        },
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "NY",
            "license": "249680-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "13035-320",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467693580",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "707 14th St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131539",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shanna530899@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "shanna530899@direct-ehr-ssmhc.com",
            "address_1": "707 14th St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAHAR",
            "last_name": "KHALIL",
            "middle_name": "GAMAL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.