Shadeed Hasan Ii, is a medicare enrolled "Behavior Analyst" provider in Stockton, California. His current practice location is
1811 Grand Canal Blvd Ste 2, Stockton, California. You can reach out to his office (for appointments etc.) via phone at
(877) 418-2978.
Shadeed Hasan Ii is licensed to practice in California (license number 1-16-22697) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003130626.
Healthcare Provider's Profile
| Full Name | Shadeed Hasan Ii |
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| Gender | Male |
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| Speciality | Behavior Analyst |
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| Location | 1811 Grand Canal Blvd Ste 2, Stockton, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003130626
- Provider Enumeration Date: 03/25/2010
- Last Update Date: 12/28/2021
Medicare PECOS Information:
- PECOS PAC ID: 2961851878
- Enrollment ID: I20231218000258
Medical Identifiers
Medical identifiers for Shadeed Hasan Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003130626 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | 36287 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW84937 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | 1-16-22697 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shadeed Hasan Ii allows following entities to bill medicare on his behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shadeed Hasan Ii is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Shadeed Hasan Ii,
500 Fairway Dr Ste 102,
Deerfield Beach, FL 33441-1817
Ph: (877) 418-2978 | Shadeed Hasan Ii,
1811 Grand Canal Blvd Ste 2,
Stockton, CA 95207-8107
Ph: (877) 418-2978 |
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