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Individual provider Active NPI

Waleed Ahmed Khalaf Hassan, MD

  • Nephrology Physician
  • Iowa City, IA
National Provider Identifier
1780171033
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD-52243 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-4185
Fax
(319) 356-2999
NPI assigned
Apr 21, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T-4354 MS
Internal Medicine Physician 207R00000X MD-52243 IA
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X
Nephrology Physician 207RN0300X MD-52243 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-4185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830002408 IA Practitioner - NephrologyPractitioner - Internal Medicine 2163771221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Hospital & facility affiliations

  • University of Iowa Hospital & Clinics Dialysis Dialysis facility, Iowa City, IA, CCN 162306
  • University of Iowa Hospital & Clinics Hospital, Iowa City, IA, CCN 160058
  • University of Iowa Health Care Medical Center Down Hospital, Iowa City, IA, CCN 160029

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
75.68
Promoting interoperability
78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T-4354MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa Single Specialty CurrentSince Aug 13, 2024 Accepting new patients
State University of Iowa Single Specialty Past Accepting new patients

Locations

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1780171033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-4185",
            "fax_number": "319-356-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-4185",
            "fax_number": "319-356-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "WALEED",
        "middle_name": "AHMED KHALAF",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-21",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-4354",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-52243",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IA",
            "license": "MD-52243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.