Individual provider Active NPI

Mahrous Abo-Hassan, MD

  • Pulmonary Disease Physician
  • Crystal River, FL
National Provider Identifier
1114335023
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME156350 Issued in FL
Practice address
1550 N Shockley LP
Crystal River, FL 34429
Phone
(352) 795-1999
Fax
(352) 795-2269
NPI assigned
Jul 24, 2014
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.130399 OH
Pulmonary Disease Physician 207RP1001X ME156350 FL Primary
Hospitalist Physician 208M00000X 35.130399 OH

Addresses

Primary practice location

1550 N Shockley LP
Crystal River, FL 34429

Mailing address

1550 N Shockley Loop
Crystal River, FL 34429-7816
Phone (352) 795-1999

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
I20250917004417 FL Practitioner - Pulmonary Disease 4587966296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manoj B Shukla MD PAGroup PAC ID 2466484621, 7 clinicians

Practice addresses (Care Compare)

1550 N Shockley Loop
Crystal River, FL 34429-7816
Phone (352) 795-1999

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
Manoj B Shukla MD PA Pulmonary Disease CurrentSince Jul 1, 2025 Accepting new patients

Locations

1550 N Shockley Loop
Crystal River, FL 34429
Phone (352) 795-1999

5616 W Norvell Bryant Hwy
Crystal River, FL 34429
Phone (352) 795-1999

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/AABFCD/Endpoint/AABFCD
  • Direct secure messaging: mabohassan362371@direct.tgh.org

Organizations & group practices 2

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": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1114335023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N SHOCKLEY LOOP",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297816",
            "telephone_number": "352-795-1999",
            "fax_number": "352-795-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N SHOCKLEY LP",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34429",
            "telephone_number": "352-795-1999",
            "fax_number": "352-795-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABO-HASSAN",
        "first_name": "MAHROUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-24",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.130399",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME156350",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.130399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal River, FL

Sources for this page

Verify at the official NPI Registry.