Tariq Hassan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4351049180 Issued in MI

Practice address

36500 S Gratiot Ave Ste 102
Clinton Township, MI 48035-1772

Phone

(586) 790-9003

Fax

(586) 493-3603

NPI assigned

Mar 28, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis Hospitalist Medical Group, Inc.Group PAC ID 2769846328, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tariq.hassan.1@16555.direct.athenahealth.com

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.

• Genesis Hospitalist Medical Group, Inc.

  • Internal Medicine Physician
  • West Hollywood, CA
  • NPI 1316641855

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1578213831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36500 S GRATIOT AVE STE 102",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351772",
            "telephone_number": "586-790-9003",
            "fax_number": "586-493-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36500 S GRATIOT AVE STE 102",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480351772",
            "telephone_number": "586-790-9003",
            "fax_number": "586-493-3603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Harrington St",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480432920",
            "country_code": "US",
            "telephone_number": "586-493-8749",
            "fax_number": "586-493-3250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "TARIQ",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351049180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles William Harrison Jr.
• Jennifer Harvey, LPC
• Sherita Harvey, LMSW
• Sumaita Raisa Hasan
• Cora Sue Haskins, LLP, LPC
• Hallie Nicole Hatcher, N/A
• Angela Brooke Hauptman, D.O.
• Adrianne Hawkins
• Brigette Denise Hawkins
• Anita Hawkshaw

• Internal Medicine Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.

Verify at the official NPI Registry.