Individual provider Active NPI

Afshan Hassan, M.D

  • Internal Medicine Physician
  • Charleston, WV
National Provider Identifier
1891229910
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME149100 Issued in FL
Practice address
3200 Maccorkle Ave SE
Robert C. Bird Clinical Training Center, 4TH Floor
Charleston, WV 25304-1227
Phone
(304) 388-5590
Fax
(304) 388-8238
NPI assigned
Apr 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 29844 WV
Internal Medicine Physician 207R00000X ME149100 FL Primary

Addresses

Primary practice location

3200 Maccorkle Ave SE
Robert C. Bird Clinical Training Center, 4TH Floor
Charleston, WV 25304-1227

Mailing address

3200 Maccorkle Ave SE Ste B16
Charleston, WV 25304-1227
Phone (304) 388-5848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20200804003184 WV Practitioner - HospitalistPractitioner - Internal Medicine 7214202142 Reassigns benefits to 1 organization
I20210810004125 FL Practitioner - Internal Medicine 7214202142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgewood Physician Services, LLCGroup PAC ID 0446594105, 47 clinicians

Practice addresses (Care Compare)

40100 Hwy 27
Davenport, FL 33837-5906
Phone (863) 422-4971

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29844WVMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Aug 1, 2020 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Ridgewood Physician Services, LLC Hospitalist CurrentSince Jul 22, 2021 Accepting new patients
Charleston Area Medical Center Inc PastSince Aug 8, 2021 Accepting new patients
Charleston Area Medical Center Inc PastSince Aug 8, 2021 Accepting new patients

Locations

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

3200 Maccorkle Ave SE
Fl 4
Charleston, WV 25304
Phone (304) 388-5590

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

3200 Maccorkle Ave SE
Ste B16
Charleston, WV 25304
Phone (304) 388-5848

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1891229910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE STE B16",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-5848",
            "fax_number": "304-388-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "address_2": "ROBERT C. BIRD CLINICAL TRAINING CENTER, 4TH FLOOR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041227",
            "telephone_number": "304-388-5590",
            "fax_number": "304-388-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "AFSHAN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2021-08-03",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WV",
            "license": "29844",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME149100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.