Individual provider Active NPI

Hisham Hanai, M.D.

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1801851332
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME74438 Issued in FL
Practice address
6350 Central Ave
St Petersburg, FL 33707-1430
Phone
(727) 381-1144
Fax
(727) 381-6901
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME74438 FL Primary

Addresses

Primary practice location

6350 Central Ave
St Petersburg, FL 33707-1430

Mailing address

6350 Central Ave
St Petersburg, FL 33707-1430
Phone (727) 381-1144

Other identifiers 2

IdentifierTypeStateIssuer
42446OtherFLBLUE CROSS BLUE SHIELD HO
015566000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050513000117 FL Practitioner - Family Practice 4981644648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Management of Florida IncGroup PAC ID 3971678558, 158 clinicians

Practice addresses (Care Compare)

2940 S US Hwy 1
Suite C11 Wellmed at Fort Pierce
Fort Pierce, FL 34982-8143
Phone (772) 466-6855

6350 Central Ave
St Petersburg, FL 33707-1430
Phone (727) 381-1144

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • HCA Florida Pasadena Hospital a Part of HCA Florid Hospital, Saint Petersburg, FL, CCN 100126
  • HCA Florida St Petersburg Hospital Hospital, Saint Petersburg, FL, CCN 100180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME74438FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas LLC Family Medicine CurrentSince Feb 15, 2019 Accepting new patients
GMS Florida West Coast Inc Family Medicine CurrentSince May 11, 2025 Accepting new patients
Wellmed Medical Management of Florida Inc Family Medicine CurrentSince May 5, 2025 Accepting new patients
Professional Health Care of Pinellas Inc. CurrentSince Feb 15, 2019 Accepting new patients
Baker Community Health Center Inc Past Accepting new patients
Omega Health and Nutrition LLC PastSince Sep 9, 2020 Accepting new patients
Radiology Associates of Tarpon Springs PA Past Accepting new patients

Locations

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

5500 Mlk Jr St N
St Petersburg, FL 33703
Phone (727) 525-5500

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

6350 Central Ave
St Petersburg, FL 33707
Phone (727) 381-1144

960 58th St N
St Petersburg, FL 33710
Phone (727) 820-7778

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

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

Organizations & group practices 7

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 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1801851332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071430",
            "telephone_number": "727-381-1144",
            "fax_number": "727-381-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337071430",
            "telephone_number": "727-381-1144",
            "fax_number": "727-381-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANAI",
        "first_name": "HISHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME74438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD HO",
            "identifier": "42446",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015566000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.