Active NPI
Polly B Hansen, M.D.
- Diagnostic Radiology Physician
- San Antonio, TX
National Provider Identifier
1902871668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- H4379
- Practice address
- 311 Camden St
Suite 208
San Antonio, TX 78215-2012 - Phone
- (210) 892-0228
- Fax
- (210) 455-0169
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | E14264 | TX | |
| Diagnostic Radiology Physician | 2085R0202X | H4379 | TX | Primary |
Addresses
Primary practice location
311 Camden St
Suite 208
San Antonio, TX 78215-2012
Mailing address
PO Box 2947
San Antonio, TX 78299-2947
Phone (210) 892-0228
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135798009 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E14264 | TX | MD | Specialist |
| H4379 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| VHS San Antonio Partners, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1831970532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489017600000",
"number": "1902871668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2947",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782992947",
"telephone_number": "210-892-0228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 CAMDEN ST",
"address_2": "SUITE 208",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782152012",
"telephone_number": "210-892-0228",
"fax_number": "210-455-0169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "POLLY",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2017-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "E14264",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "H4379",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "135798009",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.