JACK HANNA
NPI 1407610033
Student in an Organized Health Care Education/Training Program in Worcester, MA
About Jack Hanna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK HANNA (NPI 1407610033) is an individual student in an organized health care education/training program in Worcester, Massachusetts and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jack Hanna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
WORCESTER, MA 01655
WORCESTER, MA 01655
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 Jack Hanna's NPI number?
The NPI number for Jack Hanna is 1407610033. It was assigned to this individual provider in the NPPES registry on February 13, 2024.
Where is Jack Hanna located?
Jack Hanna practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 769-3530.
What is Jack Hanna's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Jack Hanna enrolled in Medicare?
Yes. Jack Hanna is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Jack Hanna was last updated on March 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Jack Hanna · NPI 1407610033
Student in an Organized Health Care Education/Training Program provider in Worcester, Massachusetts. Individual provider, active in the CMS NPPES registry since February 13, 2024.
## Identity
- **NPI:** 1407610033 (Entity type: Individual)
- **Enumerated:** February 13, 2024
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 55 LAKE AVE N, Worcester, MA 01655-0002
- **Phone:** (508) 769-3530
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1407610033) · Data from the CMS NPPES public registry.