Individual provider Active NPI

Mohamad Charif Hassan, M.D

  • Pediatrics Physician
  • Corpus Christi, TX
National Provider Identifier
1699961102
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M8705 Issued in TX
Practice address
2120 Baldwin Blvd
Corpus Christi, TX 78405-2010
Phone
(361) 500-0096
Fax
(361) 500-0098
NPI assigned
Sep 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M8705 TX Primary

Addresses

Primary practice location

2120 Baldwin Blvd
Corpus Christi, TX 78405-2010

Mailing address

PO Box 102
Beeville, TX 78104-0102
Phone (361) 362-8184

Other identifiers 2

IdentifierTypeStateIssuer
171353905MedicaidTX
171353901MedicaidTX

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
I20100427000123 TX Practitioner - Pediatric Medicine 2860529682 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8705TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Emergency Associates LLC CurrentSince Mar 30, 2016 Accepting new patients
Nueces Emergency Medicine Associates PA CurrentSince Oct 16, 2016 Accepting new patients
Victoria Pediatrics & Adolescents Assoc. Past Accepting new patients
Kids Care PLLC Pediatrics PastSince Aug 30, 2020 Accepting new patients
Antrados, P.a. Pediatrics Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Children'S Physician Services of South Texas Past Accepting new patients

Locations

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

101 Medical Dr
Victoria, TX 77904
Phone (361) 573-6100

Organizations & group practices 7

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1699961102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102",
            "city": "BEEVILLE",
            "state": "TX",
            "postal_code": "781040102",
            "telephone_number": "361-362-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 BALDWIN BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784052010",
            "telephone_number": "361-500-0096",
            "fax_number": "361-500-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "MOHAMAD",
        "middle_name": "CHARIF",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-18",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M8705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171353905",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171353901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.