Individual provider Active NPI

Kirk Hanson, D.O.

  • Family Medicine Physician
  • Hartland, WI
National Provider Identifier
1659650653
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62860 Issued in WI
Practice address
600 Walnut Ridge Dr
Hartland, WI 53029-9385
Phone
(262) 369-6902
Fax
(262) 369-6922
NPI assigned
Aug 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 62860 WI Primary
Family Medicine Physician 207Q00000X 11016285A IN

Addresses

Primary practice location

600 Walnut Ridge Dr
Hartland, WI 53029-9385

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
100040118MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address khanson124239@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20141107001501 WI Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 5991950263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2808 Heritage Dr
Delafield, WI 53018-2127
Phone (262) 646-1440

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Aurora Medical Center - Summit Hospital, Summit, WI, CCN 520206

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016285AINMDFamily Medicine Physician
62860WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2014 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

2808 Heritage Dr
Delafield, WI 53018
Phone (262) 354-8415

600 Walnut Ridge Dr
Hartland, WI 53029
Phone (262) 369-6902

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Interoperability endpoints

  • Direct secure messaging: khanson124239@direct.myadvocateaurora.org

Organizations & group practices 3

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": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1659650653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WALNUT RIDGE DR",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530299385",
            "telephone_number": "262-369-6902",
            "fax_number": "262-369-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "KIRK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-08",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "62860",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11016285A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100040118",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2808 Heritage Dr",
            "city": "Delafield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530182127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khanson124239@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2808 Heritage Dr",
            "city": "Delafield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530182127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartland, WI

Sources for this page

Verify at the official NPI Registry.