NPIMap

Individual provider Active NPI

Ali Hassan, MD

  • Internal Medicine Physician
  • Springfield, MO
National Provider Identifier
1396977062
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2012020489 Issued in MO
Practice address
3801 S. National, 5TH Floor
Springfield, MO 65807-5210
Phone
(417) 269-7728
Fax
(417) 269-7729
NPI assigned
Aug 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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 T2009011772 MO
Internal Medicine Physician 207R00000X 2012020489 MO Primary

Addresses

Primary practice location

3801 S. National, 5TH Floor
Springfield, MO 65807-5210

Mailing address

PO Box 4046
Springfield, MO 65808-4046

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171120002921 OH Practitioner - Nephrology 9133379654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Nephrology LTDGroup PAC ID 3678551330, 5 clinicians

Practice addresses (Care Compare)

970 Windham Court
Suite 6a
Boardman, OH 44512-5082

970 Windham CT
Suite 6a
Boardman, OH 44512-5082
Phone (330) 259-0440

Hospital & facility affiliations

  • Warren Dialysis Center Dialysis facility, Howland, OH, CCN 362752
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064
  • MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
  • HMHP St Elizabeth Boardman Health Center Hospital, Boardman, OH, CCN 360276
  • Surgical Hospital at Southwoods Hospital, Youngstown, OH, CCN 360352

Merit-based Incentive Payment System (MIPS)

Final score
76.93 of 100Reported as individual
Quality
48.87
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012020489MOMDInternal Medicine Physician
T2009011772MOMDInternal Medicine Physician

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 7

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1396977062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S. NATIONAL, 5TH FLOOR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-7728",
            "fax_number": "417-269-7729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-14",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "T2009011772",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012020489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.