Active NPI
Hasan Nahouli, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Grand Rapids, MI
National Provider Identifier
1194698357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 4351055450
- Practice address
- 100 Michigan St NE
Grand Rapids, MI 49503-2560 - Phone
- (616) 391-1774
- NPI assigned
- Sep 24, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Foot and Ankle Surgery Physician | 207XX0004X | 4351055450 | MI | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 4351055450 | MI | Primary |
Addresses
Primary practice location
100 Michigan St NE
Grand Rapids, MI 49503-2560
Mailing address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (248) 564-9855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251220000123 | MI | Order and Referring Only - Orthopedic Surgery | 0244725810 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351055450 | MI | MD | Orthopaedic Foot and Ankle Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1194698357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "248-564-9855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-391-1774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAHOULI",
"first_name": "HASAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-09-24",
"last_updated": "2026-08-17",
"certification_date": "2026-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0004X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
"state": "MI",
"license": "4351055450",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "MI",
"license": "4351055450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.