Jimmy R. Mascaro, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

3768 Issued in IA

Practice address

312 E Alta Vista Ave
Ottumwa, IA 52501-1413

Phone

(641) 683-4454

Fax

(641) 683-4450

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Iowa Mental Health CenterGroup PAC ID 6002809647, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Southern Iowa Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ottumwa, IA
  • NPI 1659353670
  Medicare reassignment Care Compare group NPD
• Mascaro Health, Inc.

  • Psychiatry Physician
  • Smithtown, NY
  • NPI 1952031866
  NPD Authorized official
• Mascaro Tele-Medicine P.C.

  • Psychiatry Physician
  • Smithtown, NY
  • NPI 1891647715
  NPD Authorized official
• Southern Iowa Mental Health Center

  • Community/Behavioral Health Agency
  • Ottumwa, IA
  • NPI 1457178428
  NPD
• Cornerstone Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Centerville, IA
  • NPI 1033281084
  NPD (past)
• Hillcrest Family Services

  • Primary Care Clinic/Center
  • Dubuque, IA
  • NPI 1497354773
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1104998251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E ALTA VISTA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525011413",
            "telephone_number": "641-683-4454",
            "fax_number": "641-683-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E ALTA VISTA AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525011413",
            "telephone_number": "641-683-4454",
            "fax_number": "641-683-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCARO",
        "first_name": "JIMMY",
        "middle_name": "R.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "3768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28586",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0739672",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OTHER",
            "identifier": "28587",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "IA01J4",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Ottumwa, IA
• Providers in Ottumwa, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.
• 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.