Jason Depasquale, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7407 Issued in GA

Practice address

30 Broad St FL 45
New York, NY 10004-2942

Phone

(888) 663-6331

Fax

(415) 252-7176

NPI assigned

Oct 3, 2014

Last updated

Apr 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MA, NC, OH, IL, FL, NY6 enrollments

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 6

Merit-based Incentive Payment System (MIPS)

Final score

50.89 of 100Reported as group

Quality

13.1

Promoting interoperability

100

Improvement activities

0

Cost

73.19

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oluwatoyin Ajayi Medical Practice, PC

  dba Cityblock Medical Practice

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1912491770
  Medicare reassignment NPD
• Cityblock Medical Practice, LLC

  • Primary Care Clinic/Center
  • Columbus, OH
  • NPI 1013673821
  Medicare reassignment
• Cityblock Medical Practice, P.a.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1588296784

  FL, IL, MA, NC

  Medicare reassignment
• Cityblock Ipa Ny, LLC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1407719339
  NPD

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1053714188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 PEACHTREE PL NW UNIT 1426",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303095412",
            "telephone_number": "315-439-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BROAD ST FL 45",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100042942",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 Austell Rd",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301061121",
            "country_code": "US",
            "telephone_number": "770-732-3886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3515 Camp Creek Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "East Point",
            "state": "GA",
            "postal_code": "303448411",
            "country_code": "US",
            "telephone_number": "404-344-7337",
            "fax_number": "404-344-8338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPASQUALE",
        "first_name": "JASON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-03",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029953",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13873",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9383",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18233",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Health
• Department of Neurology Professional Services Group/Slrhc
• Department of Psychiatry at Mount Sinai School of Medicine
• Larissa Depasqua, RDN
• Eugene E Depasquale, M.D.
• Lisa Depasquale
• Schevonne Depass, LPN
• Brianna Rose Depaulo, CF-SLP
• Marissa Depaulo, NP
• Hector Depaz, MD

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.