Individual provider Active NPI

Syeda I Hasan, M.D.

  • Child & Adolescent Psychiatry Physician
  • Poughkeepsie, NY
National Provider Identifier
1447370259
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MA063892 Issued in NJ
Practice address
696 Dutchess Tpke Ste 5G
Poughkeepsie, NY 12603-6444
Phone
(845) 463-2896
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 67344 CT
Child & Adolescent Psychiatry Physician 2084P0804X MA063892 NJ Primary

Addresses

Primary practice location

696 Dutchess Tpke Ste 5G
Poughkeepsie, NY 12603-6444

Mailing address

696 Dutchess Tpke Ste 5G
Poughkeepsie, NY 12603-6444
Phone (845) 463-2896

Other identifiers 1

IdentifierTypeStateIssuer
7120401MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 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
I20200417001930 NY Practitioner - Psychiatry 7012079858 Reassigns benefits to 3 organizations
I20210817003828 CT Practitioner - Psychiatry 7012079858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

696 Dutchess Tpke
Suite G
Poughkeepsie, NY 12603-6445
Phone (845) 463-2896

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA063892NJMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access: Supports for Living Inc CurrentSince Apr 20, 2022 Accepting new patients
Access: Supports for Living Inc. CurrentSince Apr 20, 2022 Accepting new patients
Natchaug Hospital, Inc. Multi-Specialty CurrentSince Aug 1, 2021 Accepting new patients
Access: Supports for Living Inc Multi-Specialty Current Accepting new patients

Locations

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

24 Union St
Middletown, NY 10940
Phone (845) 343-1173

67 Windsor Hwy
Newburgh, NY 12553
Phone (845) 562-6850

15 Fortune Rd W
Scotchtown, NY 10941
Phone (845) 673-7123

Interoperability endpoints

  • Direct secure messaging: syeda.hasan@xdr.hhchealthdirect.org

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1447370259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 DUTCHESS TPKE STE 5G",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036444",
            "telephone_number": "845-463-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 DUTCHESS TPKE STE 5G",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036444",
            "telephone_number": "845-463-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "SYEDA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "67344",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "MA063892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7120401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.