Active NPI
Teresa M Han, M.D.
- Obstetrics & Gynecology Physician
- Indianapolis, IN
National Provider Identifier
1780845909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- A119936
- Practice address
- 550 University Blvd RM 2440
Indianapolis, IN 46202-5149 - Phone
- (317) 630-6082
- NPI assigned
- Jun 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | A119936 | CA | Primary |
Addresses
Primary practice location
550 University Blvd RM 2440
Indianapolis, IN 46202-5149
Mailing address
1410 E New York St
Indianapolis, IN 46201-3021
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121001000348 | CA | Practitioner - Obstetrics/Gynecology | 3577697820 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Loma Linda University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern California Permanente Medical Group
Practice addresses (Care Compare)
1255 W Arrow Hwy
San Dimas, CA 91773-2340
Phone (909) 394-2526
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A119936 | CA | MD | Obstetrics & Gynecology Physician |
| 119936 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
1011 Baldwin Park Blvd
Baldwin Park, CA 91706
Phone (626) 851-1011
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
1255 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 394-2526
Organizations & group practices 5
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
CA
-
- Health Maintenance Organization
- Riverside, CA
- NPI 1316979834
-
- Clinical Medical Laboratory
- N Hollywood, CA
- NPI 1891873303
-
- Health Maintenance Organization
- Woodland Hills, CA
- NPI 1952333478
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710374400000",
"number": "1780845909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1410 E NEW YORK ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462013021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 UNIVERSITY BLVD RM 2440",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025149",
"telephone_number": "317-630-6082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAN",
"first_name": "TERESA",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-19",
"last_updated": "2024-03-14",
"certification_date": "2024-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "A119936",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "c-cda",
"address_1": "1011 Baldwin Park Blvd",
"city": "Baldwin Park",
"state": "CA",
"country_code": "US",
"postal_code": "917065806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.