Individual provider Active NPI

Fariba Hassani, MD

  • Internal Medicine Physician
  • Somerset, PA
National Provider Identifier
1942200670
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD062097L Issued in PA
Practice address
105 W. Church Street
Suite 1
Somerset, PA 15501-2251
Phone
(814) 445-3812
Fax
(814) 444-1852
NPI assigned
Jul 22, 2005
Reactivated
Apr 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD062097L PA Primary

Addresses

Primary practice location

105 W. Church Street
Suite 1
Somerset, PA 15501-2251

Mailing address

105 W Church Street
Suite 1
Somerset, PA 15501-2251
Phone (814) 445-3812

Other identifiers 10

IdentifierTypeStateIssuer
166984301MedicaidPA
122808OtherPABLUE CROSS/SHIELD
1526315OtherUMWA
922532OtherAETNA
110175670OtherPARR MEDICARE
PC854595OtherMAMSI
094423OtherUS HEALTHCARE
204916OtherPAUPMC HEALTH PLAN
1502227OtherPAGATEWAY HEALTH PLAN
76478OtherPATHREE RIVERS HEALTH PLAN

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD062097LPAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M. Javad Saadat, MD, PC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1942200670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W CHURCH STREET",
            "address_2": "SUITE 1",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155012251",
            "telephone_number": "814-445-3812",
            "fax_number": "814-444-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W. CHURCH STREET",
            "address_2": "SUITE 1",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155012251",
            "telephone_number": "814-445-3812",
            "fax_number": "814-444-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSANI",
        "first_name": "FARIBA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2011-04-05",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD062097L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166984301",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD",
            "identifier": "122808",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1526315",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "922532",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110175670",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "PC854595",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "094423",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC HEALTH PLAN",
            "identifier": "204916",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1502227",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS HEALTH PLAN",
            "identifier": "76478",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.