Active NPI
Abdifatah Mohamed Hassan
- Non-emergency Medical Transport (VAN)
- Milwaukee, WI
National Provider Identifier
1669156402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-emergency Medical Transport (VAN)
- License
- M5320008600115
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| M5320008600115 | WI | MD | Non-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.