Samad Nasaryab Hassan, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

2017022854 Issued in MO

Practice address

17571 N Dam Access Rd
Warsaw, MO 65355-6396

Phone

(888) 403-1071

Fax

(660) 428-1283

NPI assigned

Jul 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, NY2 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

Specialty

Psychiatry

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.97 of 100Reported as group

Quality

80.2

Improvement activities

40

Cost

72.88

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Erie County Medical Center Corporation

  • Clinic/Center
  • Buffalo, NY
  • NPI 1528233616
  Medicare reassignment Care Compare group NPD
• Compass Health, Inc

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494
  Medicare reassignment NPD
• Compass Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Rolla, MO
  • NPI 1558258632
  NPD
• Erie County Medical Center Corporation

  • Community/Retail Pharmacy
  • Buffalo, NY
  • NPI 1922768621
  NPD

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1922415751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17571 N DAM ACCESS RD",
            "city": "WARSAW",
            "state": "MO",
            "postal_code": "653556396",
            "telephone_number": "888-403-1071",
            "fax_number": "660-428-1283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 Troy Sq",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MO",
            "postal_code": "633793108",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "fax_number": "636-528-2123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 Broadway Street",
            "address_purpose": "LOCATION",
            "city": "El Dorado Springs",
            "state": "MO",
            "postal_code": "647441133",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 Mac Blvd",
            "address_purpose": "LOCATION",
            "city": "Nevada",
            "state": "MO",
            "postal_code": "647723990",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "SAMAD",
        "middle_name": "NASARYAB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2017022854",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "322713",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "322713",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MO",
            "license": "2017022854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Greer, PLPC
• Donald Wayne Grove Jr., RPH
• Andrea Lea Hane, PTA
• Merle Lane Harmon II, PLPC
• Sara Jean Harms, DC
• Nicole Hayes, RDN
• Heart Core LLC
• Darron Leon Henderson, DC
• George Holmes, LMSW
• Miranda Nicole Houk, LMSW

• Child & Adolescent Psychiatry Physician in Warsaw, MO
• Providers in Warsaw, MO by specialty
• Child & Adolescent Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.