NPIMap

Individual provider Active NPI

Ahad Manzoor Ul Hassan, M.D.

  • Interventional Cardiology Physician
  • Dalton, GA
National Provider Identifier
1003074212
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
P8032 Issued in TX
Practice address
1411 Chattanooga Ave
Dalton, GA 30720-2673
Phone
(706) 272-0272
NPI assigned
May 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 2260 WI
Student in an Organized Health Care Education/Training Program 390200000X
Interventional Cardiology Physician 207RI0011X P8032 TX Primary

Addresses

Primary practice location

1411 Chattanooga Ave
Dalton, GA 30720-2673

Mailing address

4501 Joe Ramsey Blvd E Ste 130
Greenville, TX 75401-7830
Phone (903) 201-6688

Other practice location 1

4501 Joe Ramsey Blvd E Ste 130
Greenville, TX 75401-7830
Phone (903) 201-6688

Other practice location 2

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 731-8900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AHAD.HASSAN@hca7.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160816001318 TX Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5890979504 Reassigns benefits to 1 organization
I20230221000363 NM Practitioner - Interventional Cardiology 5890979504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pecos Valley of New Mexico LLCGroup PAC ID 2466359781, 33 clinicians

Practice addresses (Care Compare)

2402 W Pierce St
Carlsbad, NM 88220-3566

2420 W Pierce St
Carlsbad, NM 88220-3518

2430 W Pierce St
Carlsbad, NM 88220-3553
Phone (575) 885-0995

4812 Roberts St
Greenville, TX 75401-5669
Phone (972) 636-4080

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting11
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P8032TXMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pecos Valley of New Mexico, LLC CurrentSince Jan 20, 2023 Accepting new patients
Cardiac Imaging Inc CurrentSince Feb 17, 2023 Accepting new patients
Elite Orthopaedics of Irving PLLC Past Accepting new patients

Locations

2402 W Pierce St
Ste 6F
Carlsbad, NM 88220
Phone (505) 887-6685

2420 W Pierce St
Ste 200
Carlsbad, NM 88220
Phone (505) 885-0600

Networks

  • NM HMO C-SNP
  • TX HMO
  • TX HMO D-SNP
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO
  • CO HMO D-SNP

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJEICD/Endpoint/HJEICD
  • Direct secure messaging: ahad.hassan@hca7.eclinicaldirectplus.com
  • Direct secure messaging: ahad.hassan.1@1739.direct.athenahealth.com
  • Direct secure messaging: ahassa04@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest Jan 3, 2024
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Jan 3, 2024
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024
Baylor Scott & White the Heart Hospital - CorinthDenton, TX, CCN 670347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1003074212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 JOE RAMSEY BLVD E STE 130",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754017830",
            "telephone_number": "903-201-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 CHATTANOOGA AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202673",
            "telephone_number": "706-272-0272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4501 Joe Ramsey Blvd E Ste 130",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "TX",
            "postal_code": "754017830",
            "country_code": "US",
            "telephone_number": "903-201-6688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-731-8900",
            "fax_number": "920-738-5369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "AHAD",
        "middle_name": "MANZOOR UL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-26",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "2260",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "P8032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AHAD.HASSAN@hca7.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4501 Joe Ramsey Blvd E Ste 130",
            "city": "Greenville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "754017830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.