Organization Active NPI

M. Michael Hanna, DO, PA

  • Primary Care Clinic/Center
  • West Palm Beach, FL
National Provider Identifier
1790183226
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
OS6942 Issued in FL
Legal business name
M. MICHAEL HANNA, DO, PA
Practice address
1411 N Flagler Dr
Suite 6300
West Palm Beach, FL 33401-3404
Phone
(561) 659-6023
Fax
(561) 659-6025
NPI assigned
Dec 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Authorized official

Name
Dr. Mousa Michael Hanna, D.O.NPI 1003885500
Title
Physician
Phone
(561) 659-6023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X OS6942 FL Primary

Addresses

Primary practice location

1411 N Flagler Dr
Suite 6300
West Palm Beach, FL 33401-3404

Mailing address

1411 N Flagler Dr
Suite 6300
West Palm Beach, FL 33401-3404
Phone (561) 659-6023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170218000114 FL Part B Supplier - Clinic/Group Practice 8527341437 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0940876M Michael Hanna DO PA1411 N Flagler Dr Suite 9400, West Palm Beach, FL 33401Certificate of waiverJul 12, 2026

National Provider Directory

National Provider Directory

Locations

1411 N Flagler Dr
Ste 6300
West Palm Beach, FL 33401
Phone (561) 659-6023

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJGIBA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1790183226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE 6300",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-659-6023",
            "fax_number": "561-659-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR",
            "address_2": "SUITE 6300",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013404",
            "telephone_number": "561-659-6023",
            "fax_number": "561-659-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. MICHAEL HANNA, DO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "MOUSA",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "561-659-6023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "OS6942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.