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LOGAN MATHEW HANSEN
NPI 1255858403
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since August 28, 2017PECOS Enrolled
2799 W GRAND BOULEVARD, MEDICAL EDUCATION DEPARTMENT, DETROIT, MI 48202(800) 436-7936 Get Directions Write a Review

NPPES record last updated: April 19, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 19, 2021, Aug 28, 2017 (2 updates tracked since 2017).

About Logan Mathew Hansen NPPES

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

LOGAN MATHEW HANSEN (NPI 1255858403) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since August 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255858403
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameLOGAN MATHEW HANSEN
Location Address2799 W GRAND BOULEVARD, MEDICAL EDUCATION DEPARTMENTDetroit, MI 48202-2689
Mailing Address2799 W Grand BlvdDetroit, MI 48202-2689
Phone(800) 436-7936
Sole ProprietorNo
Enumeration DateAugust 28, 2017
Last NPPES UpdateApril 19, 20212 updates tracked since enumeration
NPPES CertifiedApril 19, 2021
✔ NPI 1255858403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
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.

2799 W GRAND BOULEVARD, Detroit, MI 48202
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Logan Mathew Hansen 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 7

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

MR. ABDELRAHMAN ESSAM AHMED SOLIMAN ELFAHAM M.D.
Psychiatry & Neurology (Neurology)
2799 W GRAND BOULEVARD
DETROIT, MI 48202
Wayne County (313) 916-1601
DR. DANIEL NICHOLAS JOURDAN MD
Internal Medicine (Pulmonary Disease)
2799 W GRAND BOULEVARD
DETROIT, MI 48202
Wayne County (313) 916-1553
MARY GRACE FITZMAURICE PHARMD
Pharmacist (Pharmacotherapy)
2799 W GRAND BOULEVARD
DETROIT, MI 48202
Wayne County (313) 916-4622
ANAS IDRIS M.D.
Student in an Organized Health Care Education/Training Program
2799 W GRAND BOULEVARD
DETROIT, MI 48202
Wayne County (313) 916-1601
KATHERINE J. ASHMORE N.P.
Nurse Practitioner (Acute Care)
2799 W GRAND BOULEVARD, K14 CARDIOLOGY
DETROIT, MI 48202
Wayne County (313) 461-9110
ANGELI ELOISE TORRES MD
Student in an Organized Health Care Education/Training Program
2799 W GRAND BOULEVARD
DETROIT, MI 48202
Wayne County (313) 916-3284
DR. ANIEBIETABASI OKON-UMOREN M.D
Family Medicine
2799 W GRAND BOULEVARD
DETROIT, MI 48202
Wayne County (313) 916-1601

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Logan Hansen's NPI number?

The NPI number for Logan Hansen is 1255858403. It was assigned to this individual provider in the NPPES registry on August 28, 2017.

Where is Logan Hansen located?

Logan Hansen practices at 2799 W Grand Boulevard Medical Education Department, Detroit, MI 48202. The listed phone number is (800) 436-7936.

What is Logan Hansen's specialty?

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

Is Logan Hansen enrolled in Medicare?

Yes. Logan Hansen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Logan Hansen was last updated on April 19, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.