HASAN FARID HASAN OTHMAN MD
NPI 1265091128
Pediatrics in Jacksonville, IL

Q: What is Hasan Othman's NPI number?

The NPI number for Hasan Othman is 1265091128. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Q: What is Hasan Othman's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Hasan Othman was last updated on March 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 13, 2019PECOS Enrolled

15 FOUNDERS LN, JACKSONVILLE, IL 62650(217) 243-0300(217) 245-6775 Get Directions Write a Review

NPPES record last updated: March 28, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 2, 2022, Jun 13, 2019 (2 updates tracked since 2019).

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About Hasan Farid Hasan Othman Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HASAN FARID HASAN OTHMAN MD (NPI 1265091128) is an individual pediatrics provider in Jacksonville, Illinois, licensed in Illinois (036160282) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265091128

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameHASAN FARID HASAN OTHMANCredential: MD

Location Address15 FOUNDERS LNJacksonville, IL 62650-3919

Mailing Address15 Founders LnJacksonville, IL 62650-3919 · (217) 243-0300 · Fax (217) 245-6775

Phone(217) 243-0300

Fax(217) 245-6775

Sole ProprietorNo

Enumeration DateJune 13, 2019

Last NPPES UpdateMarch 28, 20242 updates tracked since enumeration

NPPES CertifiedMarch 28, 2024

✔ NPI 1265091128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in IL · 036160282

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

15 FOUNDERS LN, Jacksonville, IL 62650

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Other Identifiers 1

Other036160282IL · Il Md License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hasan Farid Hasan Othman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Hasan Othman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Memorial Physician Services

29 mi

Family Medicine

3132 OLD JACKSONVILLE RD
Springfield, IL 62704

Reassigned Medicare billing, Illinois enrollment
150 clinicians in this Medicare group

NPI 1174877930 (217) 862-0800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62650 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CORAL JEANNE ARMOUR LCSW

Social Worker (Clinical)

15 FOUNDERS LN
JACKSONVILLE, IL 62650

Morgan County (217) 291-1041

KACI N HAVLIN

Nurse Practitioner (Family)

15 FOUNDERS LN
JACKSONVILLE, IL 62650

Morgan County (217) 528-7541

ABIGAIL S WHITE MD

Surgery

15 FOUNDERS LN
JACKSONVILLE, IL 62650

Morgan County (217) 528-7541

MOLLY TAYLOR FNP

Nurse Practitioner (Family)

15 FOUNDERS LN, SUITE 100
JACKSONVILLE, IL 62650

Morgan County (217) 243-0300

KAITLYN RENEE DAVIDSON NP-C

Nurse Practitioner (Family)

15 FOUNDERS LN
JACKSONVILLE, IL 62650

Morgan County (217) 528-7541

MOSAM B PATEL M.D.

Family Medicine

15 FOUNDERS LN
JACKSONVILLE, IL 62650

Morgan County (217) 528-7541

DR. KIM WYATT MD

Family Medicine

15 FOUNDERS LN
JACKSONVILLE, IL 62650

Morgan County (217) 528-7541

BRADEN G. ANDERSON OD

Optometrist

15 FOUNDERS LN
JACKSONVILLE, IL 62650

Morgan County (217) 528-7541

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hasan Othman's NPI number?

The NPI number for Hasan Othman is 1265091128. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Where is Hasan Othman located?

Hasan Othman practices at 15 Founders Ln, Jacksonville, IL 62650. The listed phone number is (217) 243-0300.

What is Hasan Othman's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Hasan Othman enrolled in Medicare?

Yes. Hasan Othman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Hasan Othman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hasan Othman reassigns Medicare benefits to Memorial Physician Services (Springfield, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hasan Othman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Hasan Othman was last updated on March 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.