Individual provider Active NPI

Abanoub Paul Hanna

  • Emergency Medicine Physician
  • Berkeley, CA
National Provider Identifier
1568091528
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A185993 Issued in CA
Practice address
2450 Ashby Ave
Berkeley, CA 94705-2067
Phone
(510) 204-4444
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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 A185993 CA Primary

Addresses

Primary practice location

2450 Ashby Ave
Berkeley, CA 94705-2067

Mailing address

PO Box 920139
Dallas, TX 75392-0139
Phone (877) 346-2211

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230630000821 CA Practitioner - Emergency Medicine 3971962457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Tennessee, HSC, College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berkeley Emergency Medical Group IncGroup PAC ID 5890697536, 42 clinicians

Practice addresses (Care Compare)

2450 Ashby Ave
Berkeley, CA 94705-2067
Phone (510) 204-4444

Hospital & facility affiliations

  • Alta Bates Summit Medical Center Hospital, Oakland, CA, CCN 050043
  • Alta Bates Summit Medical Center - Alta Bates Camp Hospital, Berkeley, CA, CCN 050305

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.63
Improvement activities
40
Cost
81.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A185993CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients

Locations

2450 Ashby Ave
Berkeley, CA 94705
Phone (510) 204-1566

350 Hawthorne Ave
Oakland, CA 94609
Phone (510) 655-4000

Interoperability endpoints

  • Direct secure messaging: ahanna660537@hisp.ehr.sutterhealth.org

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 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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1568091528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920139",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920139",
            "telephone_number": "877-346-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ASHBY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052067",
            "telephone_number": "510-204-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "ABANOUB PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A185993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.