NATHANIAL WILLIAM HANSEN DO
NPI 1124693288
Student in an Organized Health Care Education/Training Program in Hialeah, FL

Q: What is Nathanial Hansen's NPI number?

The NPI number for Nathanial Hansen is 1124693288. It was assigned to this individual provider in the NPPES registry on May 21, 2021.

Q: What is Nathanial Hansen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Nathanial Hansen was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 21, 2021PECOS Enrolled

1475 W 49TH PL, HIALEAH, FL 33012(801) 450-8459 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 30, 2025, Apr 7, 2025, Apr 11, 2022 and 1 more (4 updates tracked since 2021).

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About Nathanial William Hansen Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NATHANIAL WILLIAM HANSEN DO (NPI 1124693288) is an individual student in an organized health care education/training program in Hialeah, Florida, licensed in Florida (OS22349) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1124693288

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameNATHANIAL WILLIAM HANSENCredential: DO

Location Address1475 W 49TH PLHialeah, FL 33012-3113

Mailing Address1475 W 49th PlHialeah, FL 33012-3113 · (801) 450-8459

Phone(801) 450-8459

Sole ProprietorYes

Enumeration DateMay 21, 2021

Last NPPES UpdateJune 30, 20254 updates tracked since enumeration

NPPES CertifiedJune 30, 2025

✔ NPI 1124693288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in FL · OS22349

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedDermatologyTaxonomy 207N00000X · License 5151015061 (MI)

1475 W 49TH PL, Hialeah, FL 33012

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Secondary Practice Locations 2

Location 128050 Grand River AveFarmington Hills, MI 48336-5919 · Phone (947) 521-8000

Location 23601 W 13 Mile RdRoyal Oak, MI 48073-6712 · Phone (248) 898-5000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nathanial William Hansen Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WILLIE PENA MD, DC

Neuromusculoskeletal Medicine & OMM