Khaled Hassan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E15898 Issued in AR

Practice address

1601 W 40TH Ave Ste 100
Pine Bluff, AR 71603-6069

Phone

(870) 541-6010

Fax

(870) 541-6009

NPI assigned

Mar 29, 2021

Last updated

Sep 27, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Family Practice

Education

Meharry Medical College School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arkansas Emergency Staffing Solutions IncGroup PAC ID 3274681341, 14 clinicians

Ess of Fordyce LLCGroup PAC ID 1254611601, 4 clinicians

Hospital Care Consultants of Fordyce LLCGroup PAC ID 5395024475, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ashley County Medical Center Hospital, Crossett, AR, CCN 041323
• Dallas County Medical Center Hospital, Fordyce, AR, CCN 041317
• Magnolia Regional Medical Center Hospital, Magnolia, AR, CCN 041336
• Baptist Health Medical Center-Drew County Hospital, Monticello, AR, CCN 040051

Merit-based Incentive Payment System (MIPS)

Final score

82.37 of 100Reported as group

Quality

71.5

Improvement activities

40

Cost

75.74

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/bradley-49d5c27e

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.

• Arkansas Emergency Staffing Solutions, Inc

  • Emergency Medicine Physician
  • Hope, AR
  • NPI 1275774630
  Medicare reassignment Care Compare group NPD
• Ess of Fordyce LLC

  • Emergency Medicine Physician
  • Fordyce, AR
  • NPI 1821547977
  Medicare reassignment Care Compare group NPD
• Hospital Care Consultants of Fordyce LLC

  • Hospitalist Physician
  • Fordyce, AR
  • NPI 1316497464
  Medicare reassignment Care Compare group NPD
• Board of Governors of Dallas County Medical Center

  dba Dallas County Medical Center ER Physicians Group

  • Emergency Medical Services (Emergency Medicine) Physician
  • Fordyce, AR
  • NPI 1043308935
  Medicare reassignment NPD
• Board of Governors of Dallas County Medical Center

  dba Dallas County Medical Center

  • Critical Access Hospital
  • Fordyce, AR
  • NPI 1306826029
  Medicare reassignment NPD
• Bradley County Medical Center

  • Critical Access Hospital
  • Warren, AR
  • NPI 1194741611
  Medicare reassignment NPD
• Bradley County Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Warren, AR
  • NPI 1861519548
  Medicare reassignment NPD
• Bradley County Medical Center

  • Critical Access Hospital
  • Warren, AR
  • NPI 1972620649
  Medicare reassignment NPD
• Ess Hospitalist LLC

  • Hospitalist Physician
  • Crossett, AR
  • NPI 1881967305
  Medicare reassignment NPD
• Ess of El Dorado, LLC

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1861851131
  Medicare reassignment NPD
• Ess of McGehee LLC

  • Emergency Medicine Physician
  • McGehee, AR
  • NPI 1639822653
  Medicare reassignment NPD
• HCC of El Dorado LLC

  • Hospitalist Physician
  • El Dorado, AR
  • NPI 1003578725
  Medicare reassignment NPD

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

• Baptist Health

  dba Baptist Health Medical Center - Drew County

  • General Acute Care Hospital
  • Monticello, AR
  • NPI 1962283192
  Care Compare affiliation
• Board of Governors of Dallas County Medical Center

  dba Dallas County Medical Center

  • Critical Access Hospital
  • Fordyce, AR
  • NPI 1306826029
  Care Compare affiliation
• Crossett Health Foundation

  dba Ashley County Medical Center

  • Critical Access Hospital
  • Crossett, AR
  • NPI 1952308215
  Care Compare affiliation
• Magnolia Regional Health System Inc

  dba Magnolia Regional Medical Center

  • Critical Access Hospital
  • Magnolia, AR
  • NPI 1700407541
  Care Compare affiliation

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1144807694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE STE 100",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036069",
            "telephone_number": "870-541-6010",
            "fax_number": "870-541-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE STE 100",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036069",
            "telephone_number": "870-541-6010",
            "fax_number": "870-541-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "KHALED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E15868",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E15898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda McCarty Harris, D.P.T.
• April Nicole Harris, FNP-C APRN
• Julie A Harris
• Briana Harrison
• Elizabeth Hartz, DNP, APRN, FNP-BC
• Kai Charmeen Hawkins
• Rae-Shem Hawkins, B.S
• Jackson Haynes, MD
• Hazel Street Nursing Association (Davis East)
• Annabeth Monet Hazlewood, APN

• Family Medicine Physician in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.