NPIMap

Individual provider Active NPI

Matthew Harvey Hanna, M.D.

  • Nephrology Physician
  • Milwaukee, WI
National Provider Identifier
1962476531
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25834 Issued in WI
Practice address
2901 W Kinnickinnic River Pkwy Ste 413
Milwaukee, WI 53215-3660
Phone
(414) 383-7744
Fax
(414) 383-8089
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25834 WI Primary

Addresses

Primary practice location

2901 W Kinnickinnic River Pkwy Ste 413
Milwaukee, WI 53215-3660

Mailing address

2514 S 102ND St
Suite 120
West Allis, WI 53227-2142
Phone (414) 777-5200

Other identifiers 1

IdentifierTypeStateIssuer
30601000MedicaidWI

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mhanna596@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address matthew.hanna@milwaukeenephrologists.directbygreenway.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20060119000678 WI Practitioner - Nephrology 9537078233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Southern Illinois University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milwaukee Nephrologists SCGroup PAC ID 4385538446, 21 clinicians

Practice addresses (Care Compare)

5650 N Green Bay Ave
Suite 210
Glendale, WI 53209-4447
Phone (414) 259-8917

Hospital & facility affiliations

  • DaVita Bay Shore Dialysis Dialysis facility, Glendale, WI, CCN 522554
  • Ara - Milwaukee Dialysis facility, Milwaukee, WI, CCN 522565
  • Concerto Wisconsin LLC Dialysis facility, Brookfield, WI, CCN 522617
  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25834WIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2008 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 1, 2008 Accepting new patients
Milwaukee Nephrologists, S.C. Nephrology CurrentSince Feb 10, 2004 Accepting new patients
Advanced Healthcare SC Past Accepting new patients
Garfield Dialysis Venture LLC Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

5650 N Green Bay Ave
Ste 210
Glendale, WI 53209
Phone (414) 247-9530

215 Washington St
Grafton, WI 53024
Phone (262) 375-3700

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2901 W Kinnickinnic River Pkwy
Ste 413
Milwaukee, WI 53215
Phone (414) 259-8917

2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 385-3084

2514 S 102nd St
Ste 120
West Allis, WI 53227

Interoperability endpoints

  • Direct secure messaging: mhanna596@direct.myadvocateaurora.org
  • Direct secure messaging: mhanna43421@direct.davitaphysiciansolutions.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71975

Organizations & group practices 5

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 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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1962476531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 S 102ND ST",
            "address_2": "SUITE 120",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272142",
            "telephone_number": "414-777-5200",
            "fax_number": "414-777-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 413",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-383-7744",
            "fax_number": "414-383-8089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "MATTHEW",
        "middle_name": "HARVEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "25834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30601000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhanna596@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2901 W Kinnickinnic River Pkwy Ste 413",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2901 W Kinnickinnic River Pkwy Ste 413",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.hanna@milwaukeenephrologists.directbygreenway.com",
            "affiliation": "N",
            "address_1": "2901 W Kinnickinnic River Pkwy Ste 413",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532153660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.