Muthanna Al Hasan, M.D.
Individual provider Active NPI Critical Care Medicine (Internal Medicine) Physician · Joplin, MO
NPI 1881827699 · NPPES record last updated Mar 6, 2013
Key facts
- NPI
- 1881827699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician 207RC0200X
- License
- 2012012807 (MO)
- Practice address
- 1102 W 32ND St
Joplin, MO 64804-3503 - Phone
- (417) 347-4570
- NPI assigned
- Aug 27, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 17
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Critical Care (Intensivists)
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Florida Hospital Healthcare Partners, Inc
Florida Hospital Medical Group Inc
Practice addresses (Care Compare)
1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000
2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone (386) 231-6000
Hospital & facility affiliations
- Adventhealth Daytona Beach
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.06 of 100
- Quality
- 62.07
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.81
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.9 of 100
- Quality
- 85.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in MO, FL, PA, MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130426000110 | MO | Practitioner - Critical Care (Intensivists) | 3577709104 | Reassigns benefits to 1 organization |
| I20170922001445 | FL | Practitioner - Critical Care (Intensivists) | 3577709104 | Reassigns benefits to 2 organizations |
| I20230331002346 | PA | Practitioner - Internal Medicine | 3577709104 | Reassigns benefits to 2 organizations |
| I20260622003117 | MI | Practitioner - Internal Medicine | 3577709104 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301095340 | MI | MD | Geriatric Medicine (Internal Medicine) Physician |
Practice roles (5 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Healthcare Partners, Inc | Current |
Accepting new patients | |
| Cogent Healthcare of Missouri, Inc | Critical Care Medicine | Current |
Accepting new patients |
| St Vincent Medical Education and Research Institute Inc | Current |
Accepting new patients | |
| Susquehanna Physician Services | Current |
Accepting new patients | |
| Susquehanna Physician Services | Critical Care Medicine | Current |
Accepting new patients |
Locations
301 Memorial Medical Pkwy
Holly Hill, FL 32117
Phone (386) 231-3906
1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000
60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000
61 Memorial Medical Pkwy
Ste 1-800A
Palm Coast, FL 32164
Phone (386) 586-1810
1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000
155 E State St
Albion, PA 16401
Phone (814) 756-4917
204 W 26th St
Erie, PA 16508
Phone (814) 454-2401
1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723
700 High St
Williamsport, PA 17701
Phone (570) 321-1000
1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005
120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040
Networks
- Freedom Health HMO Network
Interoperability endpoints
- malhasan58180@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 4301095340 | MI | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 2012012807 | MO | Yes |
Addresses
Primary practice location
1102 W 32ND St
Joplin, MO 64804-3503
Mailing address
PO Box 3810
Joplin, MO 64803-3810
Phone (417) 347-4570
Other providers in Joplin, MO
- Syed A. Ahmed
- Allicia Vivienne Ajibola
- Oluwafemi A Ajibola
- Mariam Akhtar
- Bruce A Akuna
- Asad Yasin Al-Rawashdeh
- Alan Melot LLC
- Kevin Alban
- Jennifer J. Alberty
- Katrina Anna Talactac Alcoy
All providers in Joplin, MO · Critical Care Medicine (Internal Medicine) Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.