Active NPI
Hassan Medical Pain Relief and Wellness Center
- Physical Medicine & Rehabilitation Physician
- Old Bridge, NJ
National Provider Identifier
1861045791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Legal business name
- HASSAN MEDICAL PAIN RELIEF AND WELLNESS CENTER
- Practice address
- 200 Perrine Rd Ste 209
Old Bridge, NJ 08857-2836 - Phone
- (917) 244-8332
- Fax
- (732) 587-5486
- NPI assigned
- Jul 19, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shady Hassan, MD
- Title
- Owner
- Phone
- (917) 244-8332
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | Primary |
Addresses
Primary practice location
200 Perrine Rd Ste 209
Old Bridge, NJ 08857-2836
Mailing address
316 Tennent Rd Ste 202a
Morganville, NJ 07751-1088
Phone (917) 244-8332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0598381 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
National Provider Directory
National Provider DirectoryLocations
200 Perrine Rd
Ste 209
Old Bridge, NJ 08857
Phone (732) 721-1221
1056 US Highway 9
Parlin, NJ 08859
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Brooklyn, NY
- NPI 1255560223
NJ
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563494400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1609891200000",
"number": "1861045791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 TENNENT RD STE 202A",
"city": "MORGANVILLE",
"state": "NJ",
"postal_code": "077511088",
"telephone_number": "917-244-8332",
"fax_number": "732-587-5486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PERRINE RD STE 209",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088572836",
"telephone_number": "917-244-8332",
"fax_number": "732-587-5486"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HASSAN MEDICAL PAIN RELIEF AND WELLNESS CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2019-07-19",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A",
"authorized_official_last_name": "HASSAN",
"authorized_official_first_name": "SHADY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "917-244-8332",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0598381",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Old Bridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.