Hasan Farid Hasan Othman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036160282 Issued in IL

Practice address

15 Founders LN
Jacksonville, IL 62650-3919

Phone

(217) 243-0300

Fax

(217) 245-6775

NPI assigned

Jun 13, 2019

Sex

Male

Sole proprietor

No

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.

• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1174877930

  IL

  Medicare reassignment
• Family Medical Center of Chatham, LLC

  • Family Medicine Physician
  • Chatham, IL
  • NPI 1992956528
  NPD
• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1275065906
  NPD
• Memorial Physician Services

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1417922964
  NPD
• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1528741147
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Memorial Expresscare, LLC

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1750532362

  Pediatrics

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hasanothman@memorial.allscriptsdirect.net
• Direct secure messaging: hasanothman@sfc.allscriptsdirect.net

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 28, 2024.

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1265091128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503919",
            "telephone_number": "217-243-0300",
            "fax_number": "217-245-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503919",
            "telephone_number": "217-243-0300",
            "fax_number": "217-245-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTHMAN",
        "first_name": "HASAN",
        "middle_name": "FARID HASAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036160282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL MD LICENSE",
            "identifier": "036160282",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Norton, M.D.
• Jeffrey L Olejnik, MD
• Gail C Olson
• Open MRI of Jacksonville LLC
• Open MRI of Jacksonville LLC
• Overstreet Enterprises Inc
• Rodney E. Overstreet, HIS
• Kolawole Kayode Oyewole
• Sravanthi Pallapothu, PT
• Park Place Center

• All providers in Jacksonville, IL
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.

Verify at the official NPI Registry.