Individual provider Active NPI

Haneen Saleh

  • Physician Assistant
  • Hackensack, NJ
National Provider Identifier
1649945122
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15193 Issued in TX
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
NPI assigned
Aug 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 25MP00637300 NJ
Physician Assistant 363A00000X PA15193 TX Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

23 Knickerbocker Ave
Paterson, NJ 07503-1408
Phone (862) 400-0320

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220414000371 TX Practitioner - Physician Assistant 3779979067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 820-4906

1600 Hospital Pkwy
Bedford, TX 76022-6913
Phone (817) 684-2708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00637300NJMDSurgical Critical Care Physician
PA15193TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group CurrentSince Sep 1, 2023 Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

800 5th Ave
Ste 400
Fort Worth, TX 76104
Phone (817) 702-9100

Interoperability endpoints

  • Direct secure messaging: hsaleh2029029@direct.texashealth.org

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1649945122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 KNICKERBOCKER AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075031408",
            "telephone_number": "862-400-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEH",
        "first_name": "HANEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NJ",
            "license": "25MP00637300",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.