NPIMap

Individual provider Active NPI

Ara James Hanissian, MD

  • Adolescent Medicine (Internal Medicine) Physician
  • Collierville, TN
National Provider Identifier
1679649271
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
29057 Issued in TN
Practice address
574 Green Tree CV
Suite 101
Collierville, TN 38017-2562
Phone
(901) 853-2021
Fax
(901) 853-2434
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 29057 TN Primary

Addresses

Primary practice location

574 Green Tree CV
Suite 101
Collierville, TN 38017-2562

Mailing address

574 Green Tree CV
Suite 101
Collierville, TN 38017-2562
Phone (901) 853-2021

Other identifiers 1

IdentifierTypeStateIssuer
4031484OtherTNBCBS PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090623000779 TN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6608927124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Tennessee, HSC, College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Consolidated Medical Practices of Memphis,PLLCGroup PAC ID 1759459845, 113 clinicians

Practice addresses (Care Compare)

2013 Exeter Rd
Suite 10
Germantown, TN 38138-3946
Phone (901) 737-4035

6799 Great Oaks Rd
Suite 250
Memphis, TN 38138-2584
Phone (901) 261-0700

Hospital & facility affiliations

  • Baptist Trinity Homecare & Hospice Home health agency, Cordova, TN, CCN 447407
  • Amedisys Home Care Home health agency, Memphis, TN, CCN 447538
  • Tennessee Quality Care - Home Health Home health agency, Parsons, TN, CCN 447402
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29057TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Medical Practices of Memphis,PLLC CurrentSince Jul 1, 2009 Accepting new patients
Ara James Hanissian MD PLLC Adolescent Medicine Past Accepting new patients
Harvest Health Solutions, PLLC Past Accepting new patients

Locations

574 Green Tree Cv
Ste 101
Collierville, TN 38017
Phone (901) 853-2021

6799 Great Oaks Rd
Ste 250
Memphis, TN 38138
Phone (901) 261-0700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHBDD
  • Direct secure messaging: ahanissian22225@mlh.direct-ci.com

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 7

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1679649271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "574 GREEN TREE CV",
            "address_2": "SUITE 101",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172562",
            "telephone_number": "901-853-2021",
            "fax_number": "901-853-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "574 GREEN TREE CV",
            "address_2": "SUITE 101",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172562",
            "telephone_number": "901-853-2021",
            "fax_number": "901-853-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANISSIAN",
        "first_name": "ARA",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "TN",
            "license": "29057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "4031484",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

Verify at the official NPI Registry.