Individual provider Active NPI

Nidal Hasan, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Chicago, IL
National Provider Identifier
1326024134
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036091656 Issued in IL
Practice address
1747 E 87TH St
B-390
Chicago, IL 60617-2741
Phone
(773) 978-4330
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036091656 IL Primary

Addresses

Primary practice location

1747 E 87TH St
B-390
Chicago, IL 60617-2741

Mailing address

PO Box 1200
Orland Park, IL 60462-8200
Phone (773) 820-0928

Other identifiers 2

IdentifierTypeStateIssuer
01621679OtherILBCBS OF IL
036091656MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nhasan283102@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040907000055 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 7214903848 Reassigns benefits to 1 organization
I20041117000011 IN Practitioner - EndocrinologyPractitioner - Pain ManagementPractitioner - Hospice/Palliative CarePractitioner - Osteopathic Manipulative MedicinePractitioner - Family PracticePractitioner - GastroenterologyPractitioner - General Practice 7214903848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11528 183Rd PL
Suite 1NE
Orland Park, IL 60467-9467
Phone (219) 595-5412

1747 E 87TH St
Chicago, IL 60617-2741
Phone (773) 978-4330

9108 Columbia Ave
Suite B
Munster, IN 46321-2907
Phone (219) 595-5412

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.51 of 100Reported as individual
Quality
70.42
Improvement activities
40
Cost
72.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036091656ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
N Hasan MD SC Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 2004 Accepting new patients

Locations

1747 E 87th St
#B390
Chicago, IL 60617
Phone (773) 978-4330

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

1747 E 87th St
Chicago, IL 60617
Phone (773) 783-8793

11528 183rd Pl
Ste Ne
Orland Park, IL 60467

11528 183rd Pl
Ste 1NE
Orland Park, IL 60467
Phone (219) 595-5412

9013 Indianapolis Blvd
Highland, IN 46322
Phone (574) 208-5020

9108 Columbia Ave
#B
Munster, IN 46321
Phone (219) 595-5412

9130 Columbia Ave
Ste B
Munster, IN 46321
Phone (219) 595-5412

Interoperability endpoints

  • Direct secure messaging: nhasan283102@direct.myadvocateaurora.org

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 8

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1326024134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604628200",
            "telephone_number": "773-820-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 E 87TH ST",
            "address_2": "B-390",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172741",
            "telephone_number": "773-978-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "NIDAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036091656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01621679",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091656",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhasan283102@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1747 E 87th St",
            "address_2": "B-390",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606172741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1747 E 87th St",
            "address_2": "B-390",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606172741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.