Active NPI
Robert A Hanson, P.A.-C
- Physician Assistant
- Omaha, NE
National Provider Identifier
1780602508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 677
- Practice address
- 4242 Farnam St
#150
Omaha, NE 68131-2806 - Phone
- (402) 552-6747
- Fax
- (402) 552-6741
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 677 | NE | Primary |
Addresses
Primary practice location
4242 Farnam St
#150
Omaha, NE 68131-2806
Mailing address
4242 Farnam St
#150
Omaha, NE 68131-2806
Phone (402) 552-6747
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150204002078 | NE | Order and Referring Only - Physician Assistant | 8527050558 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780602508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4242 FARNAM ST",
"address_2": "#150",
"city": "OMAHA",
"state": "NE",
"postal_code": "681312806",
"telephone_number": "402-552-6747",
"fax_number": "402-552-6741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4242 FARNAM ST",
"address_2": "#150",
"city": "OMAHA",
"state": "NE",
"postal_code": "681312806",
"telephone_number": "402-552-6747",
"fax_number": "402-552-6741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "ROBERT",
"middle_name": "A",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.