Individual provider Active NPI

Shawn Poya Hassani, MD

  • Critical Care Medicine (Anesthesiology) Physician
  • Edgewood, KY
National Provider Identifier
1437655248
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
59355 Issued in KY
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 757-2927
Fax
(859) 341-0203
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 01093323A IN
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 59355 KY Primary
Emergency Medicine Physician 207P00000X 35.141219 OH
Emergency Medicine Physician 207P00000X 2022026690 MO

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 757-2927

Other practice location 1

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (812) 496-8779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240807000792 KY Practitioner - Critical Care (Intensivists) 1759637911 Reassigns benefits to 1 organization
I20240815001015 IN Practitioner - Critical Care (Intensivists) 1759637911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Florida State University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, shared by 11 NPIs, 803 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 212-4468

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (812) 496-8771

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59355KYMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Emergency Medicine Current Accepting new patients
Summit Medical Group, Inc CurrentSince Aug 31, 2024 Accepting new patients
Summit Medical Group, Inc. CurrentSince Aug 31, 2024 Accepting new patients
Summit Medical Group, Inc. CurrentSince Aug 31, 2024 Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: shassani439702@direct-ehr-ssmhc.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1437655248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-757-2927",
            "fax_number": "859-341-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-757-2927",
            "fax_number": "859-341-0203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Wilson Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "IN",
            "postal_code": "470252751",
            "country_code": "US",
            "telephone_number": "812-496-8779",
            "fax_number": "812-537-8334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSANI",
        "first_name": "SHAWN",
        "middle_name": "POYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "IN",
            "license": "01093323A",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "KY",
            "license": "59355",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.141219",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2022026690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.