Al Hasan Makkouk, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

R1077 Issued in TX

Practice address

300 University Blvd
Round Rock, TX 78665-1032

Phone

(512) 509-0100

NPI assigned

Apr 23, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Diagnostic Radiology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Radiology Network P CGroup PAC ID 1557331261, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orthoindy Hospital Hospital, Indianapolis, IN, CCN 150160

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amakkouk266357@direct.sw.org

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.

• Northwest Radiology Network P C

  • Diagnostic Radiology Physician
  • Indianapolis, IN
  • NPI 1447259338

  Diagnostic Radiology, TX

  Medicare reassignment Care Compare group NPD
• Riverside Radiology and Interventional Associates Inc

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1093718496

  TX

  Medicare reassignment
• Btdi JV, LLP

  • Physiological Laboratory
  • San Antonio, TX
  • NPI 1194117853
  NPD
• Btdi JV, LLP

  • Physiological Laboratory
  • Austin, TX
  • NPI 1649662305
  NPD
• Btdi JV, LLP

  • Physiological Laboratory
  • Austin, TX
  • NPI 1720470487
  NPD
• Btdi JV, LLP

  • Physiological Laboratory
  • Austin, TX
  • NPI 1821480583
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana Orthopaedic Hospital, LLC

  • Special Hospital
  • Indianapolis, IN
  • NPI 1508979683

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1285809103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKKOUK",
        "first_name": "AL HASAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "1.050307",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R1077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amakkouk266357@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "300 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jackline Lydia Maina
• Egla Maiyo
• Tonya Tenise Major, LPC, NCC
• Gadalla Makar, MD
• Devyn Gail Maki
• Nymphaea Makroo
• Angela Malek, LPC
• Dayle G Malen, LCSW, M.ED.
• Mark Thomas Malone, MD
• Megan Maloney, PA-C

• All providers in Round Rock, TX
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.