DR. ALIZA HASAN (MD) – Dermatology Physician, NPI 1518581149

DR. ALIZA HASAN (MD) is a healthcare provider. based in Glen carbon, Illinois. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 036.175575 (IL). The NPI Number for DR. ALIZA HASAN (MD) is 1518581149

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALIZA HASAN (MD)
NPI
1518581149
Phone
(618) 961-1950
Address
4575 BENES AVE STE 375
Enumeration Date
29 May 2020
Last Update Date
30 January 2026

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6182440031
Graduation Year
2019 (7 years ago)
PAC ID
9335562974
Group Practice PAC ID
6709138258
Professional Enrollment ID
I20251231003912
Address ID
IL620341541GL4573XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:6State licenses:1Digital endpointsOther names

703 DERMATOLOGY in IL

Provider Addresses for DR. ALIZA HASAN (MD)

  • 4575 BENES AVE STE 375

    GLEN CARBON, IL 620341541

    Phone: (618) 961-1950

    Type: Location

  • 751 N RUTLEDGE ST

    SPRINGFIELD, IL 627024968

    Phone: (217) 545-8000

    Type: Location

  • PO BOX 19644

    SPRINGFIELD, IL 627949644

    Phone: (217) 545-8000

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251231003912IDermatologyILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62034)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709138258View full group profile
NameSpecialtyState
Nurse PractitionerMN
Nurse PractitionerKY
D E R M A T O L O G YMN
Nurse PractitionerIL
Pathology, DermatologyMO
Micrographic Dermatologic Surgery (Mds)NY
Physician AssistantIL
Physician AssistantIL

Reviews

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Frequently asked questions

Is there an official ID for DR. ALIZA HASAN (MD) in U.S. healthcare records?
The official identifier for DR. ALIZA HASAN (MD) is NPI 1518581149.
Is there an active status for DR. ALIZA HASAN (MD)?
For scheduling context, DR. ALIZA HASAN (MD) is shown as active in the registry.
What area of care is associated with DR. ALIZA HASAN (MD)?
DR. ALIZA HASAN (MD)'s record emphasizes Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where in Illinois is DR. ALIZA HASAN (MD) registered?
Use Glen Carbon, Illinois as the headline location for DR. ALIZA HASAN (MD) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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