Dwayne Maxwell Hansen Jr., DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

O-1663 Issued in ID

Practice address

381 E 4TH N Ste 100
Rexburg, ID 83440-1684

Phone

(208) 656-8442

Fax

(208) 656-8453

NPI assigned

Jun 20, 2017

Last updated

Jun 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

General Surgery

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Max Hansen Surgery PLLC

  • Surgery Physician
  • Rexburg, ID
  • NPI 1497403760
  Medicare reassignment NPD Authorized official
• Dwayne M. Hansen MD PLLC

  • Surgery Physician
  • Rexburg, ID
  • NPI 1114024650
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Madison Co Memorial Hospital

  dba Seasons Medical By Madison Memorial

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Hospital

  Care Compare affiliation
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1871013938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834400185",
            "telephone_number": "208-656-8442",
            "fax_number": "208-656-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 E 4TH N STE 100",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401684",
            "telephone_number": "208-656-8442",
            "fax_number": "208-656-8453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "DWAYNE",
        "middle_name": "MAXWELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "RL14661",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "O-1663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D Hancock, MD
• Nathan Chad Hancock, MD
• Bryant Hansen, PA-C
• David Victor Hansen, M.D.
• Dwayne M Hansen, M.D.
• Hanson Group LLC
• Douglass Eugene Hanson, OPTOMETRIST
• Troy Hanson, NP
• Rosemarie Ellen Hardin
• Scott Russell Hardy, D.O.

• Surgery Physician in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.

Verify at the official NPI Registry.