Michael Wayne Hansen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

11354TPL Issued in CA

Practice address

310 Avenue I
Redondo Beach, CA 90277-5601

Phone

(310) 373-3191

Fax

(310) 373-3979

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Michael W Hansen OD IncGroup PAC ID 3577768399, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Michael W Hansen OD Inc

  • Optometrist
  • El Segundo, CA
  • NPI 1811319478
  Medicare reassignment Care Compare group Authorized official
• Michael W Hansen OD Inc

  • Optometrist
  • Redondo Beach, CA
  • NPI 1245653617
  NPD Authorized official

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1669465035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 AVENUE I",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775601",
            "telephone_number": "310-373-3191",
            "fax_number": "310-373-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 AVENUE I",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775601",
            "telephone_number": "310-373-3191",
            "fax_number": "310-373-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11354TPL",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Hall, MFT
• Justin Masakazu Hamasu
• Katie Jane Hamilton, CNM, IBCLC
• Ashley Hansack
• Jo-Ann Hansen, M.ED., MSW, ASW
• Megan Hanson
• Aurore Harboyan, PHARMD
• Lisa Marie Hardimon, MPT
• Eryn Harman
• Celynna I Harnetiaux, MA, LMFT

• Optometrist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.

Verify at the official NPI Registry.