Individual provider Active NPI

Lartoniah Hassan

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
National Provider Identifier
1790150258
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024179288 Issued in VA
Practice address
4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone
(301) 792-9477
NPI assigned
Dec 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024179288 VA Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R197041 MD

Addresses

Primary practice location

4228 Wisconsin Ave NW
Washington, DC 20016-2138

Mailing address

8665 Sudley Rd # 228
Manassas, VA 20110-4588
Phone (301) 792-9477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210322000378 MD Practitioner - Nurse Practitioner 4486940178 Reassigns benefits to 2 organizations
I20211130001137 VA Practitioner - Nurse Practitioner 4486940178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lasting Serenity Telepsychiatry IncGroup PAC ID 3274923644, 3 clinicians

Practice addresses (Care Compare)

8665 Sudley Rd
Manassas, VA 20110-4588
Phone (571) 308-8243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024179288VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lasting Serenity Telepsychiatry Inc Psychiatric/Mental Health CurrentSince Nov 1, 2021 Accepting new patients
Pathways Inc CurrentSince Mar 12, 2021 Accepting new patients
Pathways Inc CurrentSince Mar 12, 2021 Accepting new patients

Locations

44101 Airport View Dr
Hollywood, MD 20636
Phone (301) 373-3065

2670 Crain Hwy
Ste 300
Waldorf, MD 20601
Phone (301) 373-3065

8665 Sudley Rd
Manassas, VA 20110
Phone (571) 308-8243

Organizations & group practices 4

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": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1790150258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8665 SUDLEY RD # 228",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104588",
            "telephone_number": "301-792-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "301-792-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "LARTONIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2022-08-19",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024179288",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R197041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.