Individual provider Active NPI

Laurence Gerald Hanelin, MD

  • Diagnostic Radiology Physician
  • Tucson, AZ
National Provider Identifier
1609846922
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
27584 Issued in AZ
Practice address
677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone
(520) 795-2889
Fax
(520) 795-6321
NPI assigned
Jan 26, 2006
Last updated
Jan 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X 27584 AZ
Diagnostic Radiology Physician 2085R0202X 27584 AZ Primary

Addresses

Primary practice location

677 N Wilmot Rd
Tucson, AZ 85711-2701

Mailing address

677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone (520) 795-2889

Other identifiers 7

IdentifierTypeStateIssuer
473835MedicaidAZ
1609846922OtherAZPHYSICIAN INDIVIDUAL NPI
CS7943OtherAZGROUP MEDICARE RAILROAD ID & PTAN
ZWCBBMOtherAZGROUP MEDICARE ID
005472OtherAZGROUP MEDICAID ID
1841261989OtherAZGROUP NPI
300102513OtherAZMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20100420000634 AZ Practitioner - Diagnostic Radiology 3971630179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology LTD LLCGroup PAC ID 6204727589, 107 clinicians

Practice addresses (Care Compare)

677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone (520) 571-9599

Merit-based Incentive Payment System (MIPS)

Final score
78.69 of 100Reported as group
Quality
75.27
Improvement activities
40
Cost
74.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27584AZMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RLC LLC Diagnostic Radiology CurrentSince Sep 11, 2023 Accepting new patients
Arizona Oncology Associates PC Diagnostic Radiology CurrentSince Sep 1, 2023 Accepting new patients
Radiology LTD., LLC Diagnostic Radiology CurrentSince Aug 18, 1999 Accepting new patients
Arizona State Radiology, PC Diagnostic Radiology PastSince Sep 1, 2023 Accepting new patients

Locations

2551 E Vistoso Commerce Loop
Oro Valley, AZ 85755
Phone (520) 545-1966

1598 W Commerce Ct
#A
Tucson, AZ 85746
Phone (520) 290-4842

2070 W Rudasill Rd
Ste 110
Tucson, AZ 85704
Phone (520) 797-3630

2625 N Craycroft Rd
Ste 20
Tucson, AZ 85712
Phone (520) 324-2409

2675 N Wyatt Dr
Tucson, AZ 85712
Phone (520) 260-0937

2951 N Swan Rd
Ste 155
Tucson, AZ 85712
Phone (520) 323-5900

6567 E Carondelet Dr
Ste 145
Tucson, AZ 85710
Phone (520) 290-4841

677 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 571-9599

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1609846922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889",
            "fax_number": "520-795-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889",
            "fax_number": "520-795-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANELIN",
        "first_name": "LAURENCE",
        "middle_name": "GERALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "AZ",
            "license": "27584",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "27584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "473835",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN INDIVIDUAL NPI",
            "identifier": "1609846922",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE RAILROAD ID & PTAN",
            "identifier": "CS7943",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE ID",
            "identifier": "ZWCBBM",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID ID",
            "identifier": "005472",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1841261989",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "300102513",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.