Individual provider Active NPI

Michael Dillon Hannasch, PA-C

  • Surgical Physician Assistant
  • Victoria, TX
National Provider Identifier
1588038152
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10395 Issued in TX
Practice address
105 Spring Green Blvd Ste 300
Victoria, TX 77904-7102
Phone
(361) 345-4566
Fax
(888) 849-3841
NPI assigned
Nov 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10395 TX
Surgical Physician Assistant 363AS0400X PA10395 TX Primary

Addresses

Primary practice location

105 Spring Green Blvd Ste 300
Victoria, TX 77904-7102

Mailing address

105 Spring Green Blvd Ste 300
Victoria, TX 77904-7102
Phone (361) 345-4566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160801000115 TX Practitioner - Physician Assistant 5991098790 Reassigns benefits to 3 organizations

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
Perez Orthopedics PLLCGroup PAC ID 9335536226, 3 clinicians

Practice addresses (Care Compare)

105 Spring Creek Blvd
Suite 300
Victoria, TX 77904-7100
Phone (361) 345-4566

6404 Nursery Dr
Suite 201
Victoria, TX 77904-1688
Phone (361) 345-4566

Hospital & facility affiliations

  • Citizens Medical Center Hospital, Victoria, TX, CCN 450023
  • De Tar Hospital Navarro Hospital, Victoria, TX, CCN 450147
  • Lavaca Medical Center Hospital, Hallettsville, TX, CCN 451376
  • Jackson Healthcare Center Hospital, Edna, TX, CCN 451363

Merit-based Incentive Payment System (MIPS)

Final score
94.01 of 100Reported as individual
Quality
91.29
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10395TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Orthopedic Center PLLC CurrentSince Oct 1, 2016 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

6404 Nursery Dr
Ste 202
Victoria, TX 77904
Phone (361) 333-5321

605 E San Antonio St
Ste 520E
Victoria, TX 77901
Phone (361) 576-0633

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDBEBD
  • Direct secure messaging: michael.hannasch@stos.eclinicaldirectplus.com

Organizations & group practices 5

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 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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1588038152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SPRING GREEN BLVD STE 300",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779047102",
            "telephone_number": "361-345-4566",
            "fax_number": "888-849-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SPRING GREEN BLVD STE 300",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779047102",
            "telephone_number": "361-345-4566",
            "fax_number": "888-849-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNASCH",
        "first_name": "MICHAEL",
        "middle_name": "DILLON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA10395",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA10395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

Verify at the official NPI Registry.