Hassan Jalil Kidwai, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MB09510700 Issued in NJ

Practice address

Stony Brook University Hospital
Dept. of Medicine HSC T16
Stony Brook, NY 11794-8160

Phone

(631) 444-4000

Fax

(631) 444-2493

NPI assigned

Mar 29, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Internal Medicine

Education

Touro Un Col of Osteopathic Medicine, New York, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital Hospital, Silver Spring, MD, CCN 210004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hkidwai922315@direct.umm.edu

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Halethorpe, MD
  • NPI 1043378656
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • MC Lean, VA
  • NPI 1073678637

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Largo, MD
  • NPI 1366781700

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Timonium, MD
  • NPI 1457023616
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Gaithersburg, MD
  • NPI 1497023188

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Kensington, MD
  • NPI 1578638425

  DC

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Ambulatory Surgical Clinic/Center
  • Halethorpe, MD
  • NPI 1942546486
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Internal Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Glen Burnie, MD
  • NPI 1285752121
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Gaithersburg, MD
  • NPI 1831471713
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Holy Cross Health, Inc

  • General Acute Care Hospital
  • Silver Spring, MD
  • NPI 1669417838
  NPD (past)

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

• Holy Cross Health, Inc

  • General Acute Care Hospital
  • Silver Spring, MD
  • NPI 1669417838
  Care Compare affiliation
• Holy Cross Health, Inc.

  • Clinical Medical Laboratory
  • Silver Spring, MD
  • NPI 1831574284

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1811286909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "DEPT. OF MEDICINE HSC T16",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948160",
            "telephone_number": "631-444-4000",
            "fax_number": "631-444-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "DEPT. OF MEDICINE HSC T16",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948160",
            "telephone_number": "631-444-4000",
            "fax_number": "631-444-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWAI",
        "first_name": "HASSAN",
        "middle_name": "JALIL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB09510700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1500 Forest Glen Rd",
            "city": "Silver Spring",
            "state": "MD",
            "country_code": "US",
            "postal_code": "209101460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Kholodny
• Melina Josephine Khwaja, M.D.
• Sayed M. Khwaja, D.O.
• Alecia Kidd-Francis, NP
• Ethan Kidde, MD
• Alexandra B Kiefer, MD
• Catherine Kier, M.D.
• Albert N Kim, M.D.
• Benny Sung Kim, M.D.
• Jason Michael Kim, MD

• Internal Medicine Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.

Verify at the official NPI Registry.