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

Timothy D Hanaway, MD

Individual provider Emergency Medicine Physician · NPI 1093101586

Timothy D Hanaway, MD is an Emergency Medicine in Nellis AFB, Nevada. Graduated from University of Missouri, Kansas City, School of Medicine in 2015, 11 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California and Illinois.

Years since qualifying
11
Trained at
University of Missouri, Kansas City, School of Medicine
Licensed in
CA, IL
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone: (702) 653-2344
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 036146238 (IL)
Emergency Medicine Physician Taxonomy 207P00000X · Licence A172707 (CA)

Record details

NPI number1093101586
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 10, 2015
Last updated in NPPESJanuary 13, 2023
Certification dateJuly 13, 2021

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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