Individual provider Active NPI

Shazia Mahmood Hasan, M.D.

  • Cardiovascular Disease Physician
  • Hawthorne, CA
National Provider Identifier
1073565107
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A55223 Issued in CA
Practice address
11633 Hawthorne Blvd
Suite 400
Hawthorne, CA 90250-2321
Phone
(310) 675-1400
NPI assigned
May 17, 2006
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A55223 CA Primary

Addresses

Primary practice location

11633 Hawthorne Blvd
Suite 400
Hawthorne, CA 90250-2321

Mailing address

11633 Hawthorne Blvd
Suite 400
Hawthorne, CA 90250-2321
Phone (310) 675-1400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shasan405627@oc.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060503000619 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6305856469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Southern California Keck School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians
Southern California Hospitalist Network Medical Group IncGroup PAC ID 8921990110, 76 clinicians

Practice addresses (Care Compare)

Laguna Niguel, CA 92677

1300 W 7TH St
San Pedro, CA 90732-3505
Phone (310) 303-7496

21501 Avalon Blvd
Suite 100
Carson, CA 90745-2210
Phone (310) 835-6627

3475 Torrance Blvd
Suite a
Torrance, CA 90503-5800
Phone (310) 370-3568

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 303-7496

625 The City Dr S
Suite 320
Orange, CA 92868-4978
Phone (714) 202-2330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55223CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince Oct 31, 2016 Accepting new patients
Providence Medical Institute Current Accepting new patients
Providence Medical Institute CurrentSince Oct 31, 2016 Accepting new patients
Southern California Hospitalist Network Medical Group Inc CurrentSince Nov 21, 2010 Accepting new patients
Coast Cardiology Medical Associates Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Little Company of Mary Affiliated Services Inc Past Accepting new patients
Providence Health System Southern California Past Accepting new patients
Cedars-Sinai Marina Hospital Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

11633 Hawthorne Blvd
Ste 4
Hawthorne, CA 90250
Phone (310) 677-3330

11633 Hawthorne Blvd
Ste 400
Hawthorne, CA 90250
Phone (310) 675-1400

5100 W Goldleaf Cir
Los Angeles, CA 90056
Phone (310) 853-2276

5100 W Goldleaf Cir
Fl 2
Los Angeles, CA 90056
Phone (323) 293-7171

625 The City Dr S
Ste 320
Orange, CA 92868
Phone (714) 202-2330

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

4201 Torrance Blvd
Ste 260
Torrance, CA 90503
Phone (424) 212-5333

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: shasan405627@oc.providencedirect.org

Organizations & group practices 10

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

Hospital & facility affiliations 3

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1073565107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11633 HAWTHORNE BLVD",
            "address_2": "SUITE 400",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502321",
            "telephone_number": "310-675-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11633 HAWTHORNE BLVD",
            "address_2": "SUITE 400",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502321",
            "telephone_number": "310-675-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "SHAZIA",
        "middle_name": "MAHMOOD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A55223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shasan405627@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5100 W Goldleaf Cir",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900561658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.