Individual provider Active NPI

Lara Hasan, M.D.

  • Obstetrics & Gynecology Physician
  • Palm Springs, CA
National Provider Identifier
1174888200
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A141184 Issued in CA
Practice address
1100 N Palm Canyon Dr
Suite 212
Palm Springs, CA 92262-4414
Phone
(760) 327-7900
Fax
(760) 327-7905
NPI assigned
Jul 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A141184 CA Primary

Addresses

Primary practice location

1100 N Palm Canyon Dr
Suite 212
Palm Springs, CA 92262-4414

Mailing address

1100 N Palm Canyon Dr
Suite 212
Palm Springs, CA 92262-4414
Phone (760) 327-7900

Other identifiers 3

IdentifierTypeStateIssuer
1174888200MedicaidCA
ZZZ27958ZOtherCAGROUP MEDICARE PTAN
DQ488AOtherCAGROUP MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161116002775 CA Practitioner - Obstetrics/Gynecology 6305158023 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141184CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Current Accepting new patients
Emergency Associates Corporation CurrentSince Oct 14, 2016 Accepting new patients
Magella Medical Group, Inc. Obstetrics & Gynecology CurrentSince Aug 1, 2024 Accepting new patients
Advanced Women's Healthcare, a Medical Corporation Obstetrics & Gynecology Past Accepting new patients

Locations

File 50978
Los Angeles, CA 90074

1180 N Indian Canyon Dr
Ste W300
Palm Springs, CA 92262
Phone (760) 416-3770

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: lhasan50410@direct.metrohealth.org
  • FHIR API: https://api.platform.athenahealth.com/23413/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1341360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1174888200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR",
            "address_2": "SUITE 212",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624414",
            "telephone_number": "760-327-7900",
            "fax_number": "760-327-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR",
            "address_2": "SUITE 212",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624414",
            "telephone_number": "760-327-7900",
            "fax_number": "760-327-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "LARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-04",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A141184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174888200",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "ZZZ27958Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "DQ488A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.