Active NPI
Ivan Dale Hanson, MD
- Internal Medicine Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301086414
- Practice address
- 50 E Canfield St
Detroit, MI 48201-1804 - Phone
- (313) 745-4525
- NPI assigned
- Jul 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301086414 | MI | Primary |
Addresses
Primary practice location
50 E Canfield St
Detroit, MI 48201-1804
Mailing address
130 Town Center Dr
Ste 203
Troy, MI 48084-1744
Phone (248) 585-8216
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ihanson25853@direct.beaumont.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Wayne State University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
27901 Woodward Ave
300 Beaumont Northpointe Heart Ctr
Berkley, MI 48072-0921
Phone (248) 545-0070
28100 Grand River Ave
Farmington Hills, MI 48336-5970
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535
44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone (248) 964-0400
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
- Beaumont Hospital, Troy
- Beaumont Hospital - Farmington Hills
- Beaumont Hospital - Grosse Pointe
- Beaumont Hospital - Dearborn
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 52 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301086414 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients | |
| University Physician Group | Internal Medicine | Past | Accepting new patients |
Locations
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
3601 W 13 Mile Rd
Royal Oak, MI 48073
4949 Coolidge Hwy
Royal Oak, MI 48073
Phone (248) 655-5660
Interoperability endpoints
- ihanson25853@direct.beaumont.edu
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1447299797
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1649470055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 TOWN CENTER DR",
"address_2": "STE 203",
"city": "TROY",
"state": "MI",
"postal_code": "480841744",
"telephone_number": "248-585-8216",
"fax_number": "248-585-8266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 E CANFIELD ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011804",
"telephone_number": "313-745-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "IVAN",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-23",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301086414",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ihanson25853@direct.beaumont.edu",
"affiliation": "N",
"address_1": "50 E Canfield St",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482011804",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.