NPIMap

Individual provider Active NPI

Kamil I Hanna, MD

  • Clinical Cardiac Electrophysiology Physician
  • Albany, GA
National Provider Identifier
1881632099
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
059422 Issued in GA
Practice address
425 W 3Rd Ave
Suite 600
Albany, GA 31701
Phone
(229) 431-1022
Fax
(229) 903-1369
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2001010086 MO
Clinical Cardiac Electrophysiology Physician 207RC0001X 059422 GA Primary
Cardiovascular Disease Physician 207RC0000X 059422 GA

Addresses

Primary practice location

425 W 3Rd Ave
Suite 600
Albany, GA 31701

Mailing address

P O Box 1326
Albany, GA 31702
Phone (229) 431-1022

Other identifiers 2

IdentifierTypeStateIssuer
205682511MedicaidMO
191805OtherBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000256 GA Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0749266831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

2409 N Patterson St
Suite 310
Valdosta, GA 31602-2512
Phone (229) 433-8160

Hospital & facility affiliations

  • SGMC Health Hospital, Valdosta, GA, CCN 110122
  • Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059422GAMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Putney Memorial Hospital Inc Current Accepting new patients
Phoebe Putney Memorial Hospital Inc CurrentSince Aug 1, 2007 Accepting new patients
Phoebe Women'S Services CurrentSince Aug 1, 2007 Accepting new patients
SGMC Affiliated Services LLC Current Accepting new patients
SGMC Physician Network Inc Cardiovascular Disease CurrentSince Jan 1, 2022 Accepting new patients
Phoebe Putney Memorial Hospital, Inc. Past Accepting new patients
Stuttgart Regional Medical Center Past Accepting new patients
Phoebe Putney Memorial Hospital, Inc. Past Accepting new patients
Stuttgart Regional Medical Center Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Ferrell Duncan Clinic, Inc Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

425 W 3rd Ave
Ste 600
Albany, GA 31701
Phone (229) 431-1022

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

Interoperability endpoints

  • Direct secure messaging: khanna67327@sgmc.gadirect.net

Organizations & group practices 12

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 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1881632099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1326",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31702",
            "telephone_number": "229-431-1022",
            "fax_number": "229-903-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 3RD AVE",
            "address_2": "SUITE 600",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31701",
            "telephone_number": "229-431-1022",
            "fax_number": "229-903-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "KAMIL",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2001010086",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "GA",
            "license": "059422",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "059422",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205682511",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "191805",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.