Individual provider Active NPI

Moina Hassan, MD

  • Child & Adolescent Psychiatry Physician
  • Adrian, MI
National Provider Identifier
1467535906
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
4301058960 Issued in MI
Practice address
1040 S Winter St
Adrian, MI 49221-3876
Phone
(517) 263-8905
Fax
(517) 263-7616
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 4301058960 MI Primary

Addresses

Primary practice location

1040 S Winter St
Adrian, MI 49221-3876

Mailing address

1040 S Winter St
Adrian, MI 49221-3876
Phone (517) 263-8905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040927000545 MI Practitioner - Psychiatry 3476521600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lenawee Community Mental Health AuthorityGroup PAC ID 7214828177, 8 clinicians

Practice addresses (Care Compare)

1040 S Winter St
Suite 1022
Adrian, MI 49221-3876
Phone (517) 263-8905

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lenawee Community Mental Health Authority CurrentSince Oct 1, 2001 Accepting new patients
Center for Family Psychiatry, PLC PastSince Sep 1, 2004 Accepting new patients
Lenawee Community Mental Health Authority PastSince Oct 1, 2001 Accepting new patients

Locations

1040 S Winter St
Ste 1022
Adrian, MI 49221
Phone (517) 263-8905

1200 N Main St
Adrian, MI 49221
Phone (517) 263-1800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1467535906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876",
            "telephone_number": "517-263-8905",
            "fax_number": "517-263-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 S WINTER ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492213876",
            "telephone_number": "517-263-8905",
            "fax_number": "517-263-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "MOINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301058960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.