NPIMap

Individual provider Active NPI

Roxanne M. Hanson, P.A.

  • Physician Assistant
  • Brooklyn Center, MN
National Provider Identifier
1508223074
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6000 Earle Brown Dr
Brooklyn Center, MN 55430-2506
Phone
(952) 993-4900
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MN Primary

Addresses

Primary practice location

6000 Earle Brown Dr
Brooklyn Center, MN 55430-2506

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

5435 Feltl Rd
Emergency Physicians, P.a.
Minnetonka, MN 55343-7983
Phone (952) 835-9880

Other practice location 2

5435 Feltl Rd
Emergency Physicians, P.a.
Minnetonka, MN 55343-7983
Phone (952) 835-9880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331001706 MN Practitioner - Physician Assistant 6103123484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2452MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Dec 11, 2017 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

6000 Earle Brown Dr
Minneapolis, MN 55430
Phone (952) 993-4800

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Organizations & group practices 2

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.

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": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1508223074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 EARLE BROWN DR",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302506",
            "telephone_number": "952-993-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5435 Feltl Rd",
            "address_2": "EMERGENCY PHYSICIANS, P.A.",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553437983",
            "country_code": "US",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5435 Feltl Rd",
            "address_2": "EMERGENCY PHYSICIANS, P.A.",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553437983",
            "country_code": "US",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "ROXANNE",
        "middle_name": "M.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

Verify at the official NPI Registry.