Individual provider Active NPI

Mohamed Salah M. Hassan

  • Emergency Medicine Physician
  • Beaumont, TX
National Provider Identifier
1639675655
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
T4383 Issued in TX
Practice address
3080 College St
Beaumont, TX 77701-4606
Phone
(409) 212-5000
NPI assigned
Mar 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X T4383 TX Primary

Addresses

Primary practice location

3080 College St
Beaumont, TX 77701-4606

Mailing address

1070 Lockwood Dr
Beaumont, TX 77706-5549
Phone (409) 659-5289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20221208002554 TX Practitioner - Emergency Medicine 1759638307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T4383TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Emergency Medicine Associates PLLC CurrentSince Aug 30, 2022 Accepting new patients
Tum Trans TT CurrentSince Apr 6, 2023 Accepting new patients

Locations

3080 College St
Beaumont, TX 77701
Phone (409) 212-5000

Organizations & group practices 2

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": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1639675655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 LOCKWOOD DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777065549",
            "telephone_number": "409-659-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-212-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "MOHAMED",
        "middle_name": "SALAH M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-30",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "T4383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.