Individual provider Active NPI

Cyrus Hassan, M.D

  • Military Health Care Provider
  • Fort Eustis, VA
National Provider Identifier
1184743130
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
License
9657 Issued in SC
Practice address
576 Jefferson Avenue
McDonald Army Health Clinic
Fort Eustis, VA 23604-0000
Phone
(757) 314-7754
NPI assigned
Mar 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 9657 SC Primary

Addresses

Primary practice location

576 Jefferson Avenue
McDonald Army Health Clinic
Fort Eustis, VA 23604-0000

Mailing address

106 Hailsham Palace Avenue
Yorktown, VA 23692-0000
Phone (757) 314-7994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9657SCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184743130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 HAILSHAM PALACE AVENUE",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236920000",
            "telephone_number": "757-314-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 JEFFERSON AVENUE",
            "address_2": "MCDONALD ARMY HEALTH CLINIC",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236040000",
            "telephone_number": "757-314-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "CYRUS",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "SC",
            "license": "9657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Eustis, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.