Individual provider Active NPI

Ansam Hasan, MD

  • Pediatrics Physician
  • Houston, TX
National Provider Identifier
1447754601
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
T8555 Issued in TX
Practice address
Ut Health Houston
Houston, TX 77030
Phone
(713) 500-5741
NPI assigned
Mar 22, 2018
Last updated
Jan 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X T8555 TX Primary
Pediatrics Physician 208000000X 35141986 OH
Hospitalist Physician 208M00000X 35.141986 OH

Addresses

Primary practice location

Ut Health Houston
Houston, TX 77030

Mailing address

Ut Health Houston
6431 Fannin Street
Houston, TX 77030

Other practice location 1

2213 Cherry St
Toledo, OH 43608-2603
Phone (567) 290-6543

Other practice location 2

Mercy health pediaterics
2213 franklin ave
toledo, OH 43620
Phone (419) 251-2415

Other practice location 3

2213 Franklin Ave
Toledo, OH 43620-1402
Phone (419) 251-2415

Other identifiers 1

IdentifierTypeStateIssuer
0452757MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20221205000931 TX Practitioner - Pediatric Medicine 0941557326 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.141986OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Pediatrics CurrentSince Jan 3, 2023 Accepting new patients
Ut Physicians CurrentSince Jan 3, 2023 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1447754601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UT HEALTH HOUSTON",
            "address_2": "6431 FANNIN STREET",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UT HEALTH HOUSTON",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-500-5741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436082603",
            "country_code": "US",
            "telephone_number": "567-290-6543",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Mercy health pediaterics",
            "address_2": "2213 franklin ave",
            "address_purpose": "LOCATION",
            "city": "toledo",
            "state": "OH",
            "postal_code": "43620",
            "country_code": "US",
            "telephone_number": "419-251-2415",
            "fax_number": "419-251-2422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2213 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436201402",
            "country_code": "US",
            "telephone_number": "419-251-2415",
            "fax_number": "419-251-2422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASAN",
        "first_name": "ANSAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "T8555",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35141986",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.141986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452757",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.