Individual provider Active NPI

Mahad Hassan

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1861939506
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone
(503) 231-7480
NPI assigned
Jan 19, 2017
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X T-21-555 OR
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216

Mailing address

605 SE Cesar E Chavez Blvd
Portland, OR 97214-3216
Phone (503) 231-7480

Other practice location 1

2545 N Eldorado Ave
Klamath Falls, OR 97601-6423
Phone (541) 883-3471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T-21-555ORMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1861939506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143216",
            "telephone_number": "503-231-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 SE CESAR E CHAVEZ BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143216",
            "telephone_number": "503-231-7480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2545 N Eldorado Ave",
            "address_purpose": "LOCATION",
            "city": "Klamath Falls",
            "state": "OR",
            "postal_code": "976016423",
            "country_code": "US",
            "telephone_number": "541-883-3471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "MAHAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-21-555",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.