Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nathanial William Hansen, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1124693288

Nathanial William Hansen, DO is a Dermatology in Hialeah, Florida. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2021, 5 years ago. Practices as a sole proprietor and works from 3 locations. Licensed in Florida and Michigan.

Years since qualifying
5
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
FL, MI
In the registry since
2021
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1475 W 49th Pl
Hialeah, FL 33012-3113
Phone: (801) 450-8459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 28050 Grand River Ave, Farmington Hills, MI 48336-5919 — (947) 521-8000
  • 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 — (248) 898-5000

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence OS22349 (FL)
Dermatology Physician Taxonomy 207N00000X · Licence 5151015061 (MI)

Record details

NPI number1124693288
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMay 21, 2021
Last updated in NPPESJune 30, 2025
Certification dateJune 30, 2025
Mailing address1475 W 49th Pl, Hialeah, FL 33012-3113

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Also practisesMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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