NPIMap

Individual provider Active NPI

Mohamed Hassan Halane, M.D

  • Hospitalist Physician
  • Saint Louis, MO
National Provider Identifier
1639306442
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
70739 Issued in MN
Practice address
1465 S Grand Blvd
Room 1206
Saint Louis, MO 63104-1003
Phone
(314) 577-5634
Fax
(314) 577-5616
NPI assigned
Jun 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 70739 MN
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 70739 MN Primary

Addresses

Primary practice location

1465 S Grand Blvd
Room 1206
Saint Louis, MO 63104-1003

Mailing address

4485 Barat Hall Dr
Apt. C1
Saint Louis, MO 63108-2557
Phone (908) 875-3508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180628001906 MO Practitioner - Internal Medicine 3971738725 Reassigns benefits to 3 organizations
I20220408000707 MN Practitioner - HospitalistPractitioner - Internal Medicine 3971738725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70739MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skaggs Community Hospital Association CurrentSince Jun 1, 2018 Accepting new patients
The Duluth Clinic, LTD CurrentSince Apr 11, 2022 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
St Mary'S Regional Health Center CurrentSince Nov 1, 2024 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Cogent Healthcare of Missouri, Inc CurrentSince Jan 1, 2022 Accepting new patients
Skaggs Community Hospital Association Hospitalist Current Accepting new patients
St. Mary'S Regional Health Center CurrentSince Nov 1, 2024 Accepting new patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Skaggs Community Hospital Association Hospitalist CurrentSince Jun 1, 2018 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Apr 11, 2022 Accepting new patients
Essentia Health Virginia, LLC Past Accepting new patients

Locations

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

Organizations & group practices 12

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1639306442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 BARAT HALL DR",
            "address_2": "APT. C1",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082557",
            "telephone_number": "908-875-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "address_2": "ROOM 1206",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5634",
            "fax_number": "314-577-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALANE",
        "first_name": "MOHAMED",
        "middle_name": "HASSAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "70739",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "70739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.