NPIMap

Individual provider Active NPI

Bassem G Hanna, M.D.

  • Family Medicine Physician
  • West Boylston, MA
National Provider Identifier
1437165586
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
237918 Issued in MA
Practice address
242 Woodland St
West Boylston, MA 01583-1670
Phone
(508) 835-6221
NPI assigned
Jul 31, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08783900 NJ
Family Medicine Physician 207Q00000X 237918 MA Primary

Addresses

Primary practice location

242 Woodland St
West Boylston, MA 01583-1670

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other identifiers 1

IdentifierTypeStateIssuer
0247294MedicaidNJ

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bhanna22834@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20081009000649 MA Practitioner - Family PracticePractitioner - Internal Medicine 5991800682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

242 Woodland St
West Boylston, MA 01583-1670
Phone (508) 835-6221

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08783900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Family Medicine CurrentSince Aug 31, 2013 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Aug 31, 2013 Accepting new patients
Ipc Hospitalist Physicians of New Jersey PC Past Accepting new patients
Christopher House, Inc Past Accepting new patients
Rutgers Health-PCC Monument Square Family Medicine Past Accepting new patients

Locations

242 Woodland St
West Boylston, MA 01583
Phone (508) 835-6221

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: bhanna22834@umassmemorial.direct-ci.com

Organizations & group practices 5

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 6

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1437165586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 WOODLAND ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831670",
            "telephone_number": "508-835-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "BASSEM",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-03-07",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08783900",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "237918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0247294",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhanna22834@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "242 Woodland St",
            "city": "West Boylston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "015831670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "242 Woodland St",
            "city": "West Boylston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "015831670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Boylston, MA

Sources for this page

Verify at the official NPI Registry.