Individual provider Active NPI

Shahid Hassan, M.D.

  • Internal Medicine Physician
  • Lancaster, CA
National Provider Identifier
1851401988
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A93284 Issued in CA
Practice address
43839 15TH St W
Lancaster, CA 93534-4756
Phone
(661) 945-5984
Fax
(661) 726-3890
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A93284 CA Primary
Hospitalist Physician 208M00000X A93284 CA

Addresses

Primary practice location

43839 15TH St W
Lancaster, CA 93534-4756

Mailing address

PO Box 7007
Lancaster, CA 93539-7007
Phone (661) 945-5984

Other identifiers 1

IdentifierTypeStateIssuer
00A932840MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shassan199029@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060214000706 CA Practitioner - Internal Medicine 6406861335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 303-7496

Hospital & facility affiliations

  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
93284CAMDSocial Worker
A93284CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute Internal Medicine Current Accepting new patients
Providence Medical Institute Internal Medicine CurrentSince Dec 6, 2010 Accepting new patients
Providence Medical Institute Internal Medicine CurrentSince Dec 6, 2010 Accepting new patients
Providence Health System Southern California Past Accepting new patients
Antelope Valley Health Care District Past Accepting new patients

Locations

21501 Avalon Blvd
Ste 100
Carson, CA 90745
Phone (310) 835-6627

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1851401988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7007",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935397007",
            "telephone_number": "661-945-5984",
            "fax_number": "661-726-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43839 15TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344756",
            "telephone_number": "661-945-5984",
            "fax_number": "661-726-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "SHAHID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A93284",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A93284",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A932840",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shassan199029@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4101 Torrance Blvd",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905034607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.