Active NPI
Hassan M Elmansoury, MD
- Specialist
- Fairfield, NJ
National Provider Identifier
1407076862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA03379600
- Practice address
- 695 US Highway 46
Suite 400a
Fairfield, NJ 07004-1592 - Phone
- (973) 894-1263
- Fax
- (888) 972-3703
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA03379600 | NJ | Primary |
Addresses
Primary practice location
695 US Highway 46
Suite 400a
Fairfield, NJ 07004-1592
Mailing address
PO Box 4059
Wayne, NJ 07474-4059
Phone (973) 894-1263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA03379600 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Hospital Group, Inc | Specialist | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1407076862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4059",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074744059",
"telephone_number": "973-894-1263",
"fax_number": "888-972-3703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 US HIGHWAY 46",
"address_2": "SUITE 400A",
"city": "FAIRFIELD",
"state": "NJ",
"postal_code": "070041592",
"telephone_number": "973-894-1263",
"fax_number": "888-972-3703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELMANSOURY",
"first_name": "HASSAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "MA03379600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.