Individual provider Active NPI

Clara Anne Tassinari, PA

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1073917670
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09422 Issued in TX
Practice address
14856 Preston Rd
Suite 100
Dallas, TX 75254-6822
Phone
(972) 387-8900
NPI assigned
Oct 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09422 TX Primary

Addresses

Primary practice location

14856 Preston Rd
Suite 100
Dallas, TX 75254-6822

Mailing address

PO Box 9101
Coppell, TX 75019-9494
Phone (972) 754-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180703003087 TX Practitioner - Physician Assistant 5698021640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1073917670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9101",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750199494",
            "telephone_number": "972-754-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14856 PRESTON RD",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752546822",
            "telephone_number": "972-387-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSINARI",
        "first_name": "CLARA",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.