Individual provider Active NPI

Mareena Hanna, D.O.

  • Family Medicine Physician
  • Largo, FL
National Provider Identifier
1841674546
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS14493 Issued in FL
Practice address
1345 W Bay Dr Ste 202
Largo, FL 33770-2276
Phone
(727) 559-0895
Fax
(727) 518-7633
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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 OS14493 FL Primary

Addresses

Primary practice location

1345 W Bay Dr Ste 202
Largo, FL 33770-2276

Mailing address

1345 W Bay Dr Ste 202
Largo, FL 33770-2276
Phone (727) 559-0895

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
I20180123001663 FL Practitioner - Internal MedicinePractitioner - Family Practice 4587923933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

1345 W Bay Dr
202 Optum Largo
Largo, FL 33770-2276
Phone (727) 559-0895

Hospital & facility affiliations

  • Suncoast Hospice Hospice, Palm Harbor, FL, CCN 101508

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS14493FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida LLC Family Medicine CurrentSince Oct 14, 2019 Accepting new patients
Optumcare Florida, LLC CurrentSince Oct 14, 2019 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients

Locations

1989 W Lumsden Rd
Brandon, FL 33511
Phone (813) 653-3111

1551 Main St
Dunedin, FL 34698
Phone (727) 733-5100

13220 Starkey Rd
Ste 500
Largo, FL 33773
Phone (727) 398-7701

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mareena.hanna@wellmed.eclinicaldirectplus.com

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 1

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": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1841674546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 W BAY DR STE 202",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702276",
            "telephone_number": "727-559-0895",
            "fax_number": "727-518-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W BAY DR STE 202",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702276",
            "telephone_number": "727-559-0895",
            "fax_number": "727-518-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "MAREENA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.