Individual provider Active NPI

Samira M. Hasan, D.O.

  • Surgery Physician
  • Damariscotta, ME
National Provider Identifier
1437479052
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DO2516 Issued in ME
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, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
431560263OtherMOTRICARE
P01063532OtherMORR 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150519000196 ME Practitioner - General Surgery 4587828173 Reassigns benefits to 2 organizations

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
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

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 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2516MEMDSurgery Physician
OT011661PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2018 Accepting new patients
Mainehealth CurrentSince Oct 1, 2018 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

  • Direct secure messaging: 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.

FacilityTypeRoleSince
Coves EdgeDamariscotta, ME, CCN 205067 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.

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 1

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": "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

Verify at the official NPI Registry.