Individual provider Active NPI

Hassaan Gomaa

  • Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1164914818
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD479626 Issued in PA
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
May 30, 2018
Last updated
Aug 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD479626 PA Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

101 E Olney Ave Ste 400
Philadelphia, PA 19120-2470
Phone (215) 456-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230615003329 PA Practitioner - Psychiatry 0042678419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd
Phila, PA 19141-3018
Phone (215) 456-9850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Jul 1, 2023 Accepting new patients
Einstein Practice Plan Inc Psychiatry CurrentSince Jul 1, 2023 Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

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 1

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": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1164914818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E OLNEY AVE STE 400",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202470",
            "telephone_number": "215-456-7000",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMAA",
        "first_name": "HASSAAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2023-08-08",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD479626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.