Individual provider Active NPI

Syed S Hassan, M.D.

  • Adolescent Medicine (Family Medicine) Physician
  • Woodbridge, VA
National Provider Identifier
1255372231
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
0101225821 Issued in VA
Practice address
13319 Woodbridge St
Woodbridge, VA 22191-1608
Phone
(703) 499-9921
Fax
(703) 499-9951
NPI assigned
Jun 9, 2006
Last updated
Mar 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 0101225821 VA Primary

Addresses

Primary practice location

13319 Woodbridge St
Woodbridge, VA 22191-1608

Mailing address

13319 Woodbridge St
Woodbridge, VA 22191-1608
Phone (703) 499-9921

Other identifiers 1

IdentifierTypeStateIssuer
6739709MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20110616000740 DC Practitioner - General PracticePractitioner - Family PracticePractitioner - Pediatric MedicinePractitioner - Addiction Medicine 9234260902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Addiction Medicine
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5501 Cherokee Ave
Suite 205
Alexandria, VA 22312-2305
Phone (703) 635-2775

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bismilah Medical LLC PastSince Apr 18, 2011 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1255372231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13319 WOODBRIDGE ST",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221911608",
            "telephone_number": "703-499-9921",
            "fax_number": "703-499-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13319 WOODBRIDGE ST",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221911608",
            "telephone_number": "703-499-9921",
            "fax_number": "703-499-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "SYED",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "VA",
            "license": "0101225821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6739709",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.