Active NPI
Hooman Fazlalizadeh, M.D
- Internal Medicine Physician
- Hartford, CT
National Provider Identifier
1407238264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 75926
- Practice address
- 80 Seymour St BLDG 502
Hartford, CT 06102-8000 - Phone
- (860) 972-0549
- NPI assigned
- Jun 28, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD046359 | DC | |
| Internal Medicine Physician | 207R00000X | 75926 | CT | Primary |
Addresses
Primary practice location
80 Seymour St BLDG 502
Hartford, CT 06102-8000
Mailing address
1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 972-0549
Other practice location 1
110 Irving St NW Ste 2A38M
Washington, DC 20010
Phone (202) 877-4677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231025003504 | CT | Practitioner - Internal Medicine | 5890039119 |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75926 | CT | MD | Internal Medicine Physician |
| MD046359 | DC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midstate Medical Center | Current | Accepting new patients |
Locations
435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340
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.
-
- General Acute Care Hospital
- Meriden, CT
- NPI 1154425288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696809600000",
"number": "1407238264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 SILAS DEANE HWY",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061094337",
"telephone_number": "860-972-0549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SEYMOUR ST BLDG 502",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061028000",
"telephone_number": "860-972-0549"
}
],
"practiceLocations": [
{
"address_1": "110 Irving St NW Ste 2A38M",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "20010",
"country_code": "US",
"telephone_number": "202-877-4677",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAZLALIZADEH",
"first_name": "HOOMAN",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-28",
"last_updated": "2023-10-09",
"certification_date": "2023-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DC",
"license": "MD046359",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "75926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.