Reges Alexandra Hansen, DO
Individual provider
Active NPI
Psychiatry Physician · Lutz, FL
NPI 1689324535 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1689324535
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- OS2071 (FL)
- Practice address
- 21808 State Road 54
Lutz, FL 33549-6923
- Phone
- (727) 315-8612
- NPI assigned
- Mar 24, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20220627003244 |
FL |
Order and Referring Only - Psychiatry
Practitioner - Psychiatry |
6608255302 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|
| OS2071 | FL | MD | Psychiatry Physician |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Student in an Organized Health Care Education/Training Program |
390200000X |
|
|
|
| Psychiatry Physician |
2084P0800X |
OS2071 |
FL |
Yes |
Addresses
Primary practice location
21808 State Road 54
Lutz, FL 33549-6923
Mailing address
21808 State Road 54
Lutz, FL 33549-6923
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|
| Direct Messaging Address |
Reges.Hansendo@direct.mybaycare.org |
Health Information Exchange (HIE) |
BayCare Medical Group, Inc. |