Individual provider Active NPI

Craig Eugene Hanson, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Hicksville, OH
National Provider Identifier
1578600565
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
01053849A Issued in IN
Practice address
208 Columbus St
Hicksville, OH 43526-1250
Phone
(419) 542-6692
Fax
(419) 542-6685
NPI assigned
Jan 31, 2007
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301057977 MI
Obstetrics & Gynecology Physician 207V00000X 35068533 OH
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 01053849A IN Primary

Addresses

Primary practice location

208 Columbus St
Hicksville, OH 43526-1250

Mailing address

1274 Madison Blvd
Van Wert, OH 45891-2554

Other practice location 1

140 Fox Rd Ste 201
Van Wert, OH 45891-2492
Phone (419) 238-3047

Other identifiers 2

IdentifierTypeStateIssuer
0161720MedicaidOH
200841050MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 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
I20080327000470 OH Practitioner - Obstetrics/Gynecology 6608886874 Reassigns benefits to 2 organizations
I20090331000572 IN Practitioner - Obstetrics/Gynecology 6608886874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Human Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paulding County Hospital Physician ServicesGroup PAC ID 8820983893, 17 clinicians
Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

1032 W Wayne St
Paulding, OH 45879-1545
Phone (419) 399-1104

2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone (260) 434-6076

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.61 of 100Reported as group
Quality
76.47
Promoting interoperability
100
Improvement activities
40
Cost
68.89

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301057977MIMDObstetrics & Gynecology Physician
35068533OHMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation Obstetrics & Gynecology CurrentSince Mar 1, 2024 Accepting new patients
Lutheran Medical Group LLC CurrentSince Sep 16, 2025 Accepting new patients
Lutheran Medical Group LLC CurrentSince Sep 16, 2025 Accepting new patients
Paulding County Hospital Physician Services CurrentSince Sep 2, 2021 Accepting new patients
Ohiohealth Corporation CurrentSince Mar 1, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Paulding County Hospital Past Accepting new patients

Locations

1100 Mercer Ave
Decatur, IN 46733

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

2512 E DuPont Rd
Ste 110
Fort Wayne, IN 46825
Phone (260) 434-6076

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

208 Columbus St
Hicksville, OH 43526
Phone (419) 542-6692

1032 W Wayne St
Paulding, OH 45879
Phone (419) 399-1104

1035 W Wayne St
Paulding, OH 45879
Phone (419) 399-4080

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

140 Fox Rd
Ste 201
Van Wert, OH 45891
Phone (419) 232-2077

Organizations & group practices 7

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 4

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": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1578600565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1274 MADISON BLVD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458912554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLUMBUS ST",
            "city": "HICKSVILLE",
            "state": "OH",
            "postal_code": "435261250",
            "telephone_number": "419-542-6692",
            "fax_number": "419-542-6685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Fox Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Van Wert",
            "state": "OH",
            "postal_code": "458912492",
            "country_code": "US",
            "telephone_number": "419-238-3047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "CRAIG",
        "middle_name": "EUGENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301057977",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "35068533",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "IN",
            "license": "01053849A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161720",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200841050",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hicksville, OH

Sources for this page

Verify at the official NPI Registry.