Individual provider Active NPI

Hassan Ali Hassan, M.D.

  • Hematology & Oncology Physician
  • St Augustine, FL
National Provider Identifier
1285862185
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME124175 Issued in FL
Practice address
121 Whitehall Dr
St Augustine, FL 32086-5266
Phone
(904) 825-4500
Fax
(904) 825-3672
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME124175 FL Primary

Addresses

Primary practice location

121 Whitehall Dr
St Augustine, FL 32086-5266

Mailing address

7015 A C Skinner Pkwy
Suite 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113

Other identifiers 3

IdentifierTypeStateIssuer
014998800MedicaidFL
383514OtherFLAVMED
150UWOtherFLBC BS FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20231222001398 MO Practitioner - Hematology/Oncology 9133353576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Southern Illinois University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
Oncology and Hematology Joplin
Joplin, MO 64804-4524
Phone (417) 782-7722

Hospital & facility affiliations

  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
  • Mercy Hospital Carthage Hospital, Carthage, MO, CCN 261338
  • Mercy Hospital Pittsburg, Inc Hospital, Pittsburg, KS, CCN 170006
  • Mercy Specialty Hospital Southeast Kansas Hospital, Galena, KS, CCN 170203

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Joplin LLC Internal Medicine CurrentSince Dec 15, 2023 Accepting new patients

Locations

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1285862185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 A C SKINNER PKWY",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566932",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WHITEHALL DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865266",
            "telephone_number": "904-825-4500",
            "fax_number": "904-825-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "HASSAN",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME124175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014998800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "383514",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS FL",
            "identifier": "150UW",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.