Individual provider Active NPI

Richard John Vasak, M.D.

  • Trauma Surgery Physician
  • Pasadena, CA
National Provider Identifier
1215213103
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
A125307 Issued in CA
Practice address
542 S Fair Oaks Ave
Pasadena, CA 91105-2606
Phone
(626) 397-5000
NPI assigned
Oct 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A125307 CA
Trauma Surgery Physician 2086S0127X A125307 CA Primary
Surgical Critical Care Physician 2086S0102X A125307 CA

Addresses

Primary practice location

542 S Fair Oaks Ave
Pasadena, CA 91105-2606

Mailing address

9716 Panther Hollow St
Las Vegas, NV 89141-8709
Phone (626) 737-0874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20170728002485 CA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 0941571640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
New York Medical College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1044 S Fair Oaks Ave
Suite 101
Pasadena, CA 91105-2622
Phone (626) 449-4859

Hospital & facility affiliations

  • Partners Home Health Care, Inc Home health agency, Glendora, CA, CCN 058107
  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A125307CAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard J. Vasak, M.D., Inc. CurrentSince Jun 30, 2017 Accepting new patients

Locations

35 E Glenarm St
Pasadena, CA 91105
Phone (626) 768-4415

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

1044 S Fair Oaks Ave
Ste 101
Pasadena, CA 91105
Phone (626) 449-4859

Interoperability endpoints

  • Direct secure messaging: premieresurgical.richardvasak@144321.advancedmd-direct.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1215213103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9716 PANTHER HOLLOW ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891418709",
            "telephone_number": "626-737-0874",
            "fax_number": "702-974-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052606",
            "telephone_number": "626-397-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASAK",
        "first_name": "RICHARD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-24",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A125307",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "CA",
            "license": "A125307",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CA",
            "license": "A125307",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.