David Randall Hantke, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G48701 Issued in CA

Practice address

2807 Loma Vista Rd
Suite 103
Ventura, CA 93003-1500

Phone

(805) 648-7222

Fax

(805) 648-7235

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• David R. Hantke, M.D., Inc.

  • Otolaryngology Physician
  • Ventura, CA
  • NPI 1356343172
  Authorized official Same address or phone

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1982823688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2807 LOMA VISTA RD",
            "address_2": "SUITE 103",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031500",
            "telephone_number": "805-648-7222",
            "fax_number": "805-648-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 LOMA VISTA RD",
            "address_2": "SUITE 103",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031500",
            "telephone_number": "805-648-7222",
            "fax_number": "805-648-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANTKE",
        "first_name": "DAVID",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G48701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G487010",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G487010",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "040014777",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PTAN",
            "identifier": "WG48701C",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "06B6953",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RAILROAD MEDICARE NUMBER",
            "identifier": "DH0826",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G48701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Marie Hansen, SLPA
• Gary Douglas Hansen, LCSW
• Larae Jean Hansen, MSN, PNP
• Orin Hansen, MD
• Shirley Mae Hansen, LCSW
• Kaylee Michelle Jones Hantke
• William Harbison
• Harbor Family and Pediatric Medical (Channel Islands Medical Group)
• Joan Harden, SLPCCC
• Taylor Arlana Hardge

• Otolaryngology Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.