Active NPI
Elias M Sassoon, PA
- Physician Assistant
- Hackensack, NJ
National Provider Identifier
1003831975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00059100
- Practice address
- 30 Prospect Ave
Emergency Medicine
Hackensack, NJ 07601-1914 - Phone
- (201) 996-4614
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00059100 | NJ | Primary |
Addresses
Primary practice location
30 Prospect Ave
Emergency Medicine
Hackensack, NJ 07601-1914
Mailing address
30 Prospect Ave
Emergency Medicine
Hackensack, NJ 07601-1914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Meridian Medical Group - Specialty Care, PC | Past | Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHJHBD
Organizations & group practices 5
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.
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- NPI 1215989249
-
- Durable Medical Equipment & Medical Supplies
- North Bergen, NJ
- NPI 1215734199
-
- Family Medicine Physician
- Edgewater, NJ
- NPI 1275362105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003831975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 PROSPECT AVE",
"address_2": "EMERGENCY MEDICINE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 PROSPECT AVE",
"address_2": "EMERGENCY MEDICINE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011914",
"telephone_number": "201-996-4614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASSOON",
"first_name": "ELIAS",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00059100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.