Active NPI
Mashtura Hasan, MD
- Surgery Physician
- Charleston, SC
National Provider Identifier
1629709837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- LL88064
- Practice address
- 96 Jonathan Lucas St
Charleston, SC 29425-8900 - Phone
- (843) 792-4638
- NPI assigned
- Jun 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | LL88064 | SC | Primary |
Addresses
Primary practice location
96 Jonathan Lucas St
Charleston, SC 29425-8900
Mailing address
40 Bee St Apt 326
Charleston, SC 29403-5830
Phone (571) 314-3004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221130003603 | SC | Order and Referring Only - General Surgery | 4981072675 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655596800000",
"number": "1629709837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 BEE ST APT 326",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294035830",
"telephone_number": "571-314-3004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 JONATHAN LUCAS ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294258900",
"telephone_number": "843-792-4638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASAN",
"first_name": "MASHTURA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-19",
"last_updated": "2022-06-19",
"certification_date": "2022-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "LL88064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.