Ty O Hanson (NPI# 1396804597, PAC ID# 4284735598) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1396804597 |
| PAC ID by PECOS | 4284735598 |
| Professional Enrollment ID | I20070730000832 |
| Full Name | Ty O Hanson |
| Organization Legal Name | PRAIRIE DERMATOLOGY PC |
| Address |
201 S Lloyd St Suite E206 Aberdeen SD 57401-4509 |
| Phone Number | 6052260560 |
| Gender | M |
| Medical School | PIKEVILLE COLLEGE SCHOOL OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2002 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 7719079193 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 430014 | AVERA ST LUKES |
| Address | Phone | Organization |
|---|---|---|
| 201 S Lloyd St, Suite E206, Aberdeen, SD 57401-4509 | 6052260560 | PRAIRIE DERMATOLOGY PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 100% | |
| MIPS_EC_138_overall | Melanoma: Coordination of Care | 100% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_337_overall | Tuberculosis (TB) Prevention for Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier | 98% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 99% |
| Organization Legal Name | PRAIRIE DERMATOLOGY PC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryanne L Waage | Physician Assistant | Prairie Dermatology PC | 201 S Lloyd St, Suite E206, Aberdeen, SD 57401-4509 |
| Street Address |
201 S LLOYD ST SUITE E206 |
| City | ABERDEEN |
| State | SD |
| Zip | 57401-4509 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Xiaolin Deng | Psychiatry | Avera St Lukes | 201 S Lloyd St, E201 Avera Medical Group Psychiatric, Aberdeen, SD 57401-4509 |
| Sanjay Mukerji | Plastic and Reconstructive Surgery | 201 S Lloyd St, Suite W230, Aberdeen, SD 57401-4522 | |
| Thomas L Luzier | Allergy/immunology | 201 S Lloyd St, W190, Aberdeen, SD 57401-4509 | |
| Ryanne L Waage | Physician Assistant | Prairie Dermatology PC | 201 S Lloyd St, Suite E206, Aberdeen, SD 57401-4509 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roger W Werth | General Surgery | Avera St Lukes | 310 S Pennysylvania St, 201 Avera Surgical Associates, Aberdeen, SD 57401 |
| David Ring | General Surgery | Avera St Lukes | 310 S Pennysylvania St, 201 Avera Surgical Associates, Aberdeen, SD 57401 |
| Jason D Gauer | Physical Therapy | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Paul A Bormes | Anesthesiology | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Stephanie L Lenards | Physical Therapy | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Patrick J Miller | Orthopedic Surgery | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Seth Anderson | Physician Assistant | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Chad A Falken | Physical Therapy | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Matthew C Reynen | Orthopedic Surgery | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Angela Marie Mackner | Nurse Practitioner | Avera St Lukes | 701 8th Ave Nw, Avera Med Grp Ortho Surgery, Aberdeen, SD 57401-1865 |
| Find all physicians in zip 57401 | |||
| City | ABERDEEN |
| Zip Code | 57401 |
| Specialty | DERMATOLOGY |
| City + Specialty | ABERDEEN + DERMATOLOGY |
Please comment or provide details below to improve the information on Ty O Hanson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.