Active NPI
Haitham Hassane, MBBCH
- Rheumatology Physician
- Carbondale, IL
National Provider Identifier
1487065546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 036146447
- Practice address
- 2601 W Main St
Carbondale, IL 62901-1031 - Phone
- (618) 549-5361
- Fax
- (618) 351-4878
- NPI assigned
- May 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 036146447 | IL | Primary |
Addresses
Primary practice location
2601 W Main St
Carbondale, IL 62901-1031
Mailing address
PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036.146447 | Other | IL | ILLINOIS PHYSICIAN LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hhassane25553@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Physical Therapy Holdings Inc
Practice addresses (Care Compare)
2421 W Main St
Suite a
Carbondale, IL 62901-1039
Phone (618) 529-3201
2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361
Hospital & facility affiliations
- St Joseph Memorial Hospital
- Herrin Hospital
- Memorial Hospital of Carbondale
- Harrisburg Medical Center
- Good Samaritan Regional HLTH Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 82 of 100
- Quality
- 55.9
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.01
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036146447 | IL | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Medical Services, NFP | Current | Accepting new patients |
Locations
1239 E Main St
Carbondale, IL 62901
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Mount Vernon, IL
- NPI 1609897339
-
- General Acute Care Hospital
- Harrisburg, IL
- NPI 1073580130
-
- General Acute Care Hospital
- Carbondale, IL
- NPI 1093801797
-
- Critical Access Hospital
- Murphysboro, IL
- NPI 1356435135
-
- General Acute Care Hospital
- Herrin, IL
- NPI 1528158573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1487065546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3988",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629023988",
"telephone_number": "618-457-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 W MAIN ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629011031",
"telephone_number": "618-549-5361",
"fax_number": "618-351-4878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSANE",
"first_name": "HAITHAM",
"credential": "MBBCH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-12",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "IL",
"license": "036146447",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS PHYSICIAN LICENSE",
"identifier": "036.146447",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hhassane25553@sih.direct-ci.com",
"affiliation": "N",
"address_1": "2601 W Main St",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011031",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.