Active NPI
Waheed Ul Hassan, MD
- Internal Medicine Physician
- Bloomington, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036170960
- Practice address
- 1505 Eastland Dr
Bloomington, IL 61701-3534 - Phone
- (309) 662-3311
- Fax
- (309) 662-9709
- NPI assigned
- Jul 7, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351047784 | MI | |
| Internal Medicine Physician | 207R00000X | 036170960 | IL | Primary |
Addresses
Primary practice location
1505 Eastland Dr
Bloomington, IL 61701-3534
Mailing address
G3230 Beecher Rd Ste 2
Flint, MI 48532-3604
Phone (810) 342-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 W Reynolds St
Pontiac, IL 61764-9774
403 E 1St St
Dixon, IL 61021-3116
Phone (815) 288-5531
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Medical Center
- Osf Saint Katharine Medical Center
- Saint James Hospital
- St Mary Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036170960 | IL | MD | Internal Medicine Physician |
| 4351047784 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Internal Medicine | Current | Accepting new patients |
Locations
1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dixon, IL
- NPI 1508683590
-
- General Acute Care Hospital
- Pontiac, IL
- NPI 1407808090
-
- General Acute Care Hospital
- Galesburg, IL
- NPI 1164485363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1801467295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "G3230 BEECHER RD STE 2",
"city": "FLINT",
"state": "MI",
"postal_code": "485323604",
"telephone_number": "810-342-5800",
"fax_number": "810-342-5810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 EASTLAND DR",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617013534",
"telephone_number": "309-662-3311",
"fax_number": "309-662-9709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSAN",
"first_name": "WAHEED UL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-07",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4351047784",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036170960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.