NPIMap

Individual provider Active NPI

Mina Fawzi Fahim Hanna, M.D

  • Diagnostic Radiology Physician
  • Houston, TX
National Provider Identifier
1912286949
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
Q4596 Issued in TX
Practice address
6431 Fannin St
Houston, TX 77030-1501
Phone
(713) 500-7631
NPI assigned
Aug 9, 2011
Last updated
Jan 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Q4596 TX Primary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X BP10041249 TX

Addresses

Primary practice location

6431 Fannin St
Houston, TX 77030-1501

Mailing address

11502 Bay Ledge Dr
Pearland, TX 77584-8186
Phone (214) 529-5730

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-8896
Phone (214) 648-2122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20250428002868 WV Practitioner - Diagnostic Radiology 2062711534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Medical Ctr Dr
Morgantown, WV 26506-1200
Phone (304) 293-4500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10041249TXMDDiagnostic Neuroimaging (Radiology) Physician
Q4596TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Jan 31, 2025 Accepting new patients
West Virginia University Medical Corporation Single Specialty CurrentSince Jan 31, 2025 Accepting new patients

Locations

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1912286949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11502 BAY LEDGE DR",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775848186",
            "telephone_number": "214-529-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-7631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753908896",
            "country_code": "US",
            "telephone_number": "214-648-2122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNA",
        "first_name": "MINA",
        "middle_name": "FAWZI FAHIM",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q4596",
            "primary": true
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "TX",
            "license": "BP10041249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.