Individual provider Active NPI

Rashedul Hasan, MD

  • Internal Medicine Physician
  • Victorville, CA
National Provider Identifier
1376169730
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P105251 Issued in NY
Practice address
16850 Bear Valley Rd
Victorville, CA 92395-5795
Phone
(760) 241-8000
NPI assigned
Jun 22, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A205905 CA
Internal Medicine Physician 207R00000X P105251 NY Primary

Addresses

Primary practice location

16850 Bear Valley Rd
Victorville, CA 92395-5795

Mailing address

13042 Larrera St
Etiwanda, CA 91739-9505
Phone (760) 241-8000

Other identifiers 1

IdentifierTypeStateIssuer
ND18642DMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200911001271 NY Practitioner - Internal Medicine 1951729623 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P105251NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Internal Medicine PLLC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Nys Medical Associate PLLC Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Infinite Medical PC CurrentSince Feb 9, 2023 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

11915 27th Ave
Flushing, NY 11354
Phone (631) 681-4754

10201 66th Rd
#1B
Forest Hills, NY 11375

16411 Chapin Pkwy
Jamaica, NY 11432
Phone (718) 296-7800

6135 Dry Harbor Rd
Middle Vlg, NY 11379
Phone (718) 505-7500

130 Lake Ave S
Nesconset, NY 11767
Phone (631) 636-0620

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1376169730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13042 LARRERA ST",
            "city": "ETIWANDA",
            "state": "CA",
            "postal_code": "917399505",
            "telephone_number": "760-241-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16850 BEAR VALLEY RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955795",
            "telephone_number": "760-241-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "RASHEDUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A205905",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P105251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ND18642D",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.