Individual provider Active NPI

Masoumeh Jaleh Hassaninejad-Farahani, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1376513929
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
220312 Issued in NY
Practice address
3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone
(718) 920-8888
Fax
(718) 920-7451
NPI assigned
Jan 25, 2006
Last updated
Nov 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 220312 NY Primary

Addresses

Primary practice location

3400 Bainbridge Ave
Bronx, NY 10467-2404

Mailing address

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (718) 920-8888

Other identifiers 1

IdentifierTypeStateIssuer
02147377MedicaidNY

Other names 1

  • Dr. Masoumeh Jaleh Hassaninejad Other name

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address jaf9029@direct.nyp.org Direct

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
I20110430000006 NY Practitioner - Internal Medicine 6204011554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lawrence Medical Associates PCGroup PAC ID 1759439631, 226 clinicians

Practice addresses (Care Compare)

540 Gramatan Ave
Mount Vernon, NY 10552-2104
Phone (914) 668-5944

685 White Plains Rd
Eastchester, NY 10709-5545

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220312NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence Medical Associates, PC Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Lawrence Medical Associates, PC CurrentSince Apr 1, 2016 Accepting new patients
New York-Presbyterian/Lawrence Hospital Past Accepting new patients

Locations

685 White Plains Rd
Fl 2
Eastchester, NY 10709
Phone (914) 787-4100

685 White Plains Rd
Lowr
Eastchester, NY 10709
Phone (914) 787-4100

540 Gramatan Ave
Mount Vernon, NY 10552
Phone (855) 756-2496

2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jaf9029@direct.nyp.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1376513929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-8888",
            "fax_number": "718-920-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-8888",
            "fax_number": "718-920-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSANINEJAD-FARAHANI",
        "first_name": "MASOUMEH",
        "middle_name": "JALEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "220312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02147377",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "540 Gramatan Ave",
            "city": "Mount Vernon",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105522104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "540 Gramatan Ave",
            "city": "Mount Vernon",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105522104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jaf9029@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "540 Gramatan Ave",
            "city": "Mount Vernon",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105522104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MASOUMEH",
            "last_name": "HASSANINEJAD",
            "middle_name": "JALEH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.