Individual provider Active NPI

Mohammed Hassan, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lakeland, FL
National Provider Identifier
1083877682
Registry record updated Jul 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME102306 Issued in FL
Practice address
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone
(863) 687-1068
Fax
(863) 687-1069
NPI assigned
Jul 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X R8008 TX
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD2013-0056 NM
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4301097735 MI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 35.086907 OH
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X ME102306 FL Primary

Addresses

Primary practice location

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543

Mailing address

1324 Lakeland Hills Blvd
Manage Care Dept
Lakeland, FL 33805
Phone (863) 687-1100

Other practice location 1

10525 Montgomery Rd
Cincinnati, OH 45242
Phone (513) 745-9800

Other practice location 2

10525 Montgomery Rd
Cincinnati, OH 45242
Phone (513) 745-9800

Other identifiers 1

IdentifierTypeStateIssuer
1083877682MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mhassan17687@LRHS.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200928001481 FL Practitioner - Thoracic Surgery 1456539261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Lakeland, FL, CCN 107282
  • Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Merit-based Incentive Payment System (MIPS)

Final score
86.12 of 100Reported as group
Quality
64.08
Promoting interoperability
98
Improvement activities
40
Cost
76.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)14
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME102306FLMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD2013-0056NMMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35.086907OHMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
R8008TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles (1 of 3)

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Oct 27, 2020 Accepting new patients

Locations

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: mhassan17687@lrhs.direct-ci.com
  • Direct secure messaging: mhassan422213@direct.sw.org
  • Direct secure messaging: mhassan320548@ahs.direct-ci.com

Organizations & group practices 1

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 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": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1083877682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "MANAGE CARE DEPT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-687-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-687-1068",
            "fax_number": "863-687-1069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10525 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45242",
            "country_code": "US",
            "telephone_number": "513-745-9800",
            "fax_number": "513-246-4050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10525 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45242",
            "country_code": "US",
            "telephone_number": "513-745-9800",
            "fax_number": "513-246-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "R8008",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NM",
            "license": "MD2013-0056",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301097735",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "35.086907",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME102306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083877682",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhassan17687@LRHS.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1324 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338054543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.