Individual provider Active NPI

Jacob Bernard Hanin, MD

  • Internal Medicine Physician
  • Owensboro, KY
National Provider Identifier
1700306859
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
54016 Issued in KY
Practice address
1201 Pleasant Valley Rd
Owensboro, KY 42303-9811
Phone
(270) 417-4700
Fax
(270) 417-4709
NPI assigned
Jun 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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 54016 KY Primary

Addresses

Primary practice location

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

Mailing address

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811
Phone (270) 417-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200708001518 KY Practitioner - Internal Medicine 3274804166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

2211 Mayfair Dr
Owensboro, KY 42301-4569

811 E Parrish Ave
Owensboro, KY 42303-3258

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-9491

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54016KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jul 1, 2020 Accepting new patients
Owensboro Health Inc Past Accepting new patients

Locations

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: jhanin104266@direct.owensborohealth.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 6

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1700306859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PLEASANT VALLEY RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039811",
            "telephone_number": "270-417-4700",
            "fax_number": "270-417-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PLEASANT VALLEY RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039811",
            "telephone_number": "270-417-4700",
            "fax_number": "270-417-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANIN",
        "first_name": "JACOB",
        "middle_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "54016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.