Active NPI
Samira M. Hasan, D.O.
- Surgery Physician
- Damariscotta, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- DO2516
- Practice address
- 24 Miles Center Way
Damariscotta, ME 04543-4047 - Phone
- (207) 563-4252
- Fax
- (207) 563-4275
- NPI assigned
- Jun 5, 2010
- Last updated
- Oct 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | OT011661 | PA | |
| Surgery Physician | 208600000X | 2012007469 | MO | |
| Surgery Physician | 208600000X | DO2516 | ME | Primary |
Addresses
Primary practice location
24 Miles Center Way
Damariscotta, ME 04543-4047
Mailing address
24 Miles Center Way
Damariscotta, ME 04543-4047
Phone (207) 563-4252
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431560263 | Other | MO | TRICARE |
| P01063532 | Other | MO | RR MCR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
35 Mile St
Damariscotta, ME 04543-4047
Phone (207) 563-1234
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.93 of 100
- Quality
- 83.31
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO2516 | ME | MD | Surgery Physician |
| OT011661 | PA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Past | Accepting new patients |
Locations
24 Miles Center Way
Damariscotta, ME 04543
Phone (207) 563-4250
35 Miles St
Damariscotta, ME 04543
Phone (207) 563-1234
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
Interoperability endpoints
- shasan118863@direct.mmc.mainehealth.org
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Coves Edge | Skilled nursing facility | Corporate Director Trustee of the SNF |
Oct 1, 2017 Oct 1, 2017 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Coves Edge Nursing Facility
- Nursing Facility/Intermediate Care Facility
- Damariscotta, ME
- NPI 1477648962
Corporate Director, Trustee of the SNF
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.
-
dba MaineHealth Lincoln Hospital
- Critical Access Hospital
- Damariscotta, ME
- NPI 1912094806
-
dba MaineHealth Pharmacy Brighton Ave
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba MaineHealth Lincoln Hospital
- Critical Access Hospital
- Damariscotta, ME
- NPI 1912094806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1437479052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 MILES CENTER WAY",
"city": "DAMARISCOTTA",
"state": "ME",
"postal_code": "045434047",
"telephone_number": "207-563-4252",
"fax_number": "207-563-4275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 MILES CENTER WAY",
"city": "DAMARISCOTTA",
"state": "ME",
"postal_code": "045434047",
"telephone_number": "207-563-4252",
"fax_number": "207-563-4275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASAN",
"first_name": "SAMIRA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-05",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "OT011661",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2012007469",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "ME",
"license": "DO2516",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "431560263",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "P01063532",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Damariscotta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.