Individual provider Active NPI

Sameena Shireen Hassan, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1093746489
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
200401496 Issued in NC
Practice address
1315 East Blvd
Suite 280
Charlotte, NC 28203-5975
Phone
(704) 384-1866
Fax
(704) 384-1867
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 200401496 NC Primary

Addresses

Primary practice location

1315 East Blvd
Suite 280
Charlotte, NC 28203-5975

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7283

Other identifiers 3

IdentifierTypeStateIssuer
13875OtherNCBCBS
5901118MedicaidNC
N96005MedicaidSC

Other names 1

  • Sameena Hassan Evers Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address severs15601@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050301000544 NC Practitioner - Pediatric Medicine 1557314630 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200401496NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NH Digital Health Services, LLC CurrentSince Oct 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2020 Accepting new patients
NH Digital Health Services, LLC CurrentSince Oct 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

3545 Whitehall Park Dr
Ste 300
Charlotte, NC 28273
Phone (704) 316-6187

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: severs15601@direct.novanthealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1093746489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7283",
            "fax_number": "704-316-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 EAST BLVD",
            "address_2": "SUITE 280",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035975",
            "telephone_number": "704-384-1866",
            "fax_number": "704-384-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "SAMEENA",
        "middle_name": "SHIREEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200401496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13875",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901118",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N96005",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "severs15601@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1315 East Blvd",
            "address_2": "Suite 280",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMEENA",
            "last_name": "EVERS",
            "middle_name": "HASSAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.