Active NPI
Jasen K Issa, PA-C
- Physician Assistant
- Nashville, TN
National Provider Identifier
1134483944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3006
- Practice address
- 2001 Glen Echo Rd
Nashville, TN 37215-2807 - Phone
- (615) 292-0012
- Fax
- (615) 279-9997
- NPI assigned
- Jun 26, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50003536 | OH | |
| Physician Assistant | 363A00000X | 3006 | TN | Primary |
Addresses
Primary practice location
2001 Glen Echo Rd
Nashville, TN 37215-2807
Mailing address
2001 Glen Echo Rd
Nashville, TN 37215-2807
Phone (615) 292-0012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0072950 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50003536 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Toledo Urgent Cares, LLC. | Past | Accepting new patients | |
| Mercy Medical Partners Northern Region Specialty Care LLC | Physician Assistant | Past | Accepting new patients |
| Promedica Central Physicians | Physician Assistant | Past | Accepting new patients |
Interoperability endpoints
- jissa82718@direct.bsmhealth.org
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Toledo, OH
- NPI 1982993010
-
- Surgery Physician
- Defiance, OH
- NPI 1730701749
Physician Assistant
-
- Family Medicine Physician
- Toledo, OH
- NPI 1043270150
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470182400000",
"number": "1134483944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 GLEN ECHO RD",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372152807",
"telephone_number": "615-292-0012",
"fax_number": "615-279-9997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 GLEN ECHO RD",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372152807",
"telephone_number": "615-292-0012",
"fax_number": "615-279-9997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISSA",
"first_name": "JASEN",
"middle_name": "K",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-26",
"last_updated": "2016-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50003536",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "3006",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0072950",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.