NICHOLAS MICHAEL HANNA (MD) – Diagnostic Radiology Physician, NPI 1720617962

NICHOLAS MICHAEL HANNA (MD) is a healthcare provider. based in Kansas city, Missouri. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 2021023178 (MO). The NPI Number for NICHOLAS MICHAEL HANNA (MD) is 1720617962

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS MICHAEL HANNA (MD)
NPI
1720617962
Phone
(913) 642-4900
Address
2800 CLAY EDWARDS DR
Enumeration Date
8 April 2020
Last Update Date
18 June 2025

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
9136424900
Graduation Year
2020 (6 years ago)
PAC ID
9931523115
Group Practice PAC ID
4284689043
Professional Enrollment ID
I20250616000166
Address ID
MO640348983GR1448XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:6State licenses:3Digital endpointsOther names

1,218 DIAGNOSTIC RADIOLOGY in MO

Provider Addresses for NICHOLAS MICHAEL HANNA (MD)

  • 2800 CLAY EDWARDS DR

    KANSAS CITY, MO 641163220

    Phone: (913) 642-4900

    Type: Mailing

  • 3901 Rainbow Blvd

    Kansas City, KS 661601570

    Phone: (913) 588-5000

    Type: Location

  • PO BOX 711

    WARRENSBURG, MO 640930711

    Phone: (660) 441-5919

    Type: Mailing

  • 1400 W 22ND ST

    SIOUX FALLS, SD 571051570

    Phone: (605) 357-1386

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250616000166IDiagnostic RadiologyMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64116)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4284689043View full group profile
NameSpecialtyState
Diagnostic RadiologyKS
Diagnostic RadiologyMO
Diagnostic RadiologyMO
Diagnostic RadiologyKS
Diagnostic RadiologyMO
Diagnostic RadiologyMO
Diagnostic RadiologyMO
Diagnostic RadiologyMO
Diagnostic RadiologyMO
-MO

Reviews

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Frequently asked questions

Is there an official ID for NICHOLAS MICHAEL HANNA (MD) in U.S. healthcare records?
The official identifier for NICHOLAS MICHAEL HANNA (MD) is NPI 1720617962.
Is NICHOLAS MICHAEL HANNA (MD) still an active registrant?
NICHOLAS MICHAEL HANNA (MD) carries an active NPI according to the public dataset.
How would a patient describe NICHOLAS MICHAEL HANNA (MD)'s focus?
For NICHOLAS MICHAEL HANNA (MD), the primary taxonomy reads as Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with NICHOLAS MICHAEL HANNA (MD)?
Directory geography for NICHOLAS MICHAEL HANNA (MD) centers on Kansas City, Missouri.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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