Individual provider Active NPI

Abdifatah Mohamed Hassan

  • Non-emergency Medical Transport (VAN)
  • Milwaukee, WI
National Provider Identifier
1669156402
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
M5320008600115 Issued in WI
Practice address
5068 S 14TH St
Milwaukee, WI 53221-3536
Phone
(414) 719-6723
NPI assigned
Jun 12, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X M5320008600115 WI Primary

Addresses

Primary practice location

5068 S 14TH St
Milwaukee, WI 53221-3536

Mailing address

5068 S 14TH St
Milwaukee, WI 53221-3536
Phone (414) 719-6723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M5320008600115WIMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1669156402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5068 S 14TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532213536",
            "telephone_number": "414-719-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5068 S 14TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532213536",
            "telephone_number": "414-719-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMED HASSAN",
        "first_name": "ABDIFATAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "WI",
            "license": "M5320008600115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.