Susan J Hanson (NPI# 1114966751, PAC ID# 8820058985) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1114966751 |
| PAC ID by PECOS | 8820058985 |
| Professional Enrollment ID | I20041013000503 |
| Full Name | Susan J Hanson |
| Organization Legal Name | INTERNAL MEDICINE ASSOCIATES |
| Address |
4450 31st Ave S Suite 102 Fargo ND 58104-4532 |
| Phone Number | 7012802033 |
| Gender | F |
| Credential | PA |
| Medical School | UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE |
| Graduation Year | 2004 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 8527027879 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 350011 | SANFORD MEDICAL CENTER FARGO |
| 350070 | ESSENTIA HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 | 7012802033 | INTERNAL MEDICINE ASSOCIATES |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | INTERNAL MEDICINE ASSOCIATES |
| Physicians | 36 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaitlyn Wells | Nurse Practitioner | Internal Medicine Associates | 6940 Winton Blount Blvd, Montgomery, AL 36117-3556 |
| Melissa Ann Bruce | Nurse Practitioner | Internal Medicine Associates | 1711 W Wheeler, Suite 3, Aransas Pass, TX 78336-4530 |
| Lindsay Vettleson | Registered Dietitian Or Nutrition Professional | Internal Medicine Associates | 1707 Gold Dr S, Fargo, ND 58103-6413 |
| Ahmad B Shughoury | Gastroenterology | Internal Medicine Associates | 8895 Broadway, Merrillville, IN 46410-7037 |
| Ronald L Hays | Internal Medicine | Internal Medicine Associates | 501 Medical Ctr Dr, Suite 3c, Alexandria, LA 71301-8124 |
| William J Dailey | Internal Medicine | Internal Medicine Associates | 6940 Winton Blount Blvd, Montgomery, AL 36117-3556 |
| Kumar Venkatachalam | Gastroenterology | Internal Medicine Associates | 1201 S Main St, Rm 203, Crown Point, IN 46307-8481 |
| Steven G Clemenson | Internal Medicine | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Omar Said Nehme | Gastroenterology | Internal Medicine Associates | 1201 S Main St, Rm 203, Crown Point, IN 46307-8481 |
| Brent M Hella | Internal Medicine | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Street Address |
4450 31ST AVE S SUITE 102 |
| City | FARGO |
| State | ND |
| Zip | 58104-4532 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven G Clemenson | Internal Medicine | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Brent M Hella | Internal Medicine | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Tracey Dillon | Registered Dietitian Or Nutrition Professional | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Mark G Yohe | Internal Medicine | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Dacia C Engberg | Physician Assistant | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Ronovan Lavaine Ottenbacher | Internal Medicine | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Michael John Lillestol | Internal Medicine | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Karissa M Emerson | Nurse Practitioner | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Pamela P Holtz | Nurse Practitioner | Internal Medicine Associates | 4450 31st Ave S, Suite 102, Fargo, ND 58104-4532 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Parth A Vyas | Orthopedic Surgery | Sanford Medical Center Fargo | 2301 25th St S, Fargo, ND 58104 |
| Breana B Ritchie | Nurse Practitioner | Sanford Medical Center Fargo | 2301 25th St S, Fargo, ND 58104 |
| Glenda G Trochmann | Clinical Social Worker | Deer Oaks Mental Health Associates PC | 201 S University Dr, Fargo, ND 58104-1775 |
| Su Ann Ng | Diagnostic Radiology | Medical Imaging of Lehigh Valley PC | 4222 Clubhouse Dr S, Fargo, ND 58104-3332 |
| Martha Slade Kearns | Diagnostic Radiology | Medical Imaging of Lehigh Valley PC | 4222 Clubhouse Dr S, Fargo, ND 58104-3332 |
| Crystal R Wring | Physical Therapy | Caring Edge Op LLC | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Sarah Coplin | Physical Therapy | Caring Edge Op LLC | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Marcus Anthony Sickler | Occupational Therapy | Caring Edge Op LLC | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Mckayla M Artz | Physical Therapy | Horizon Therapy, Inc. | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Alyssa J Shirek | Occupational Therapy | Horizon Therapy, Inc. | 4420 37th Ave S, Fargo, ND 58104-3400 |
| Find all physicians in zip 58104 | |||
| City | FARGO |
| Zip Code | 58104 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | FARGO + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Susan J 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.