| Glen T Hansen, MD | |
|
9200 W Wisconsin Ave, Milwaukee, WI 53226 | |
| (414) 805-3750 | |
| (414) 259-9290 |
| Full Name | Glen T Hansen |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 23 Years |
| Location | 9200 W Wisconsin Ave, Milwaukee, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679754675 | NPI | - | NPPES |
| P00620399 | Other | OH | RAILROAD MEDICARE |
| 2839101 | Medicaid | OH | |
| 1679754675 | Medicaid | WI |
| Facility Name | Location | Facility Type |
|---|---|---|
| Froedtert Memorial Lutheran Hospital | Milwaukee, WI | Hospital |
| Hillcrest Hospital | Mayfield heights, OH | Hospital |
| Cleveland Clinic | Cleveland, OH | Hospital |
| Community Memorial Hospital | Menomonee falls, WI | Hospital |
| Ashtabula County Medical Center | Ashtabula, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Clinic Medical Services Company, Llc | 5698674653 | 229 |
| The Medical College Of Wisconsin Inc | 2668384371 | 1902 |
| Cleveland Clinic Health Services Professional Association, Inc | 3577813005 | 63 |
| Froedtert Andthe Medical College Of Wisconsin Community Physicians Inc | 3678760063 | 1105 |
| Entity Name | Clinic Medical Services Company |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528013984 PECOS PAC ID: 5698674653 Enrollment ID: O20040108000271 |
| Mailing Address | Practice Location Address |
|---|---|
| Glen T Hansen, MD 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 Ph: (414) 805-3750 | Glen T Hansen, MD 9200 W Wisconsin Ave, Milwaukee, WI 53226 Ph: (414) 805-3750 |
Dr. Hong Chen, MD Radiology Medicare: Medicare Enrolled Practice Location: 9200 W Wisconsin Ave, Department Of Radiology, Milwaukee, WI 53226 Phone: 414-805-3700 Fax: 414-805-3777 | |
Dr. Alessandro Vidoni, Radiology Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-2060 | |
Sujan Fernando, Radiology Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Department Of Radiology, Milwaukee, WI 53226 Phone: 414-805-3750 Fax: 414-259-9290 | |
Dr. Zacharias P Zitterkopf, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2900 W Oklahoma Ave, Milwaukee, WI 53215 Phone: 414-649-6000 Fax: 414-649-5296 | |
Javier Alberto Lopez Puebla, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 9200 W. Wisconsin Ave, Hub Radiology 3740-4, Milwaukee, WI 53226 Phone: 414-955-1195 Fax: 414-259-9290 | |
James Benjamin Moroney, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 8701 W Watertown Plank Rd, Milwaukee, WI 53226 Phone: 414-456-6800 | |
Allan Vannostrand, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 945 N 12th St, Ste E360, Milwaukee, WI 53233 Phone: 414-219-7226 |