NPIMap

Individual provider Active NPI

Shenggao Han, MD

  • Internal Medicine Physician
  • Indiana, PA
National Provider Identifier
1679558746
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 422988 Issued in PA
Practice address
625 Rustic Lodge Rd
Suite B
Indiana, PA 15701-3440
Phone
(724) 463-3720
Fax
(724) 463-6111
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD 422988 PA Primary

Addresses

Primary practice location

625 Rustic Lodge Rd
Suite B
Indiana, PA 15701-3440

Mailing address

625 Rustic Lodge Rd
Suite B
Indiana, PA 15701-3440
Phone (724) 463-3720

Other identifiers 1

IdentifierTypeStateIssuer
101036860MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031208000039 PA Practitioner - Internal Medicine 8729983291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shenggao Han, M.D., LLCGroup PAC ID 5799680310, 5 clinicians

Practice addresses (Care Compare)

625 Rustic Lodge Rd
Indiana, PA 15701-3440
Phone (724) 463-3720

Hospital & facility affiliations

  • Visiting Nurse Association of Indiana County Home health agency, Indiana, PA, CCN 397097
  • Medi Home Health Agency Inc Home health agency, Pittsburgh, PA, CCN 397607
  • Penn Hospice, Inc Hospice, Ebensburg, PA, CCN 391776
  • 365 Hospice LLC Hospice, Carrolltown, PA, CCN 391774
  • Indiana Regional Medical Center Hospital, Indiana, PA, CCN 390173
  • Communities at Indian Haven, Nursing home, Indiana, PA, CCN 395778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 422988PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shenggao Han, M.D., LLC Internal Medicine CurrentSince Sep 2, 2003 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Shenggao Han MD LLC Internal Medicine Past Accepting new patients
Shenggao Han MD LLC Past Accepting new patients

Locations

625 Rustic Lodge Rd
Indiana, PA 15701
Phone (724) 463-3720

1177 S 6th St
Ste D
Indiana, PA 15701
Phone (724) 349-0200

625 Rustic Lodge Rd
Ste B
Indiana, PA 15701
Phone (724) 463-3720

Interoperability endpoints

  • Direct secure messaging: shan@csim.adaptamed.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1679558746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 RUSTIC LODGE RD",
            "address_2": "SUITE B",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013440",
            "telephone_number": "724-463-3720",
            "fax_number": "724-463-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 RUSTIC LODGE RD",
            "address_2": "SUITE B",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013440",
            "telephone_number": "724-463-3720",
            "fax_number": "724-463-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAN",
        "first_name": "SHENGGAO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD 422988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101036860",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.