NPIMap

Organization Active NPI

Plessen Medical Group, LLC

  • Urgent Care Clinic/Center
  • Christiansted, VI
National Provider Identifier
1225639412
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PLESSEN MEDICAL GROUP, LLC
Practice address
Sunny Isles Shopping Center
Space #1, 2, and 3a
Christiansted, VI 00820
Phone
(340) 715-7720
NPI assigned
Nov 4, 2020
Last updated
Feb 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PLESSEN MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Authorized official

Name
Jan TawakolNPI 1750375671
Title
Ceo
Phone
(602) 885-3917

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

Sunny Isles Shopping Center
Space #1, 2, and 3a
Christiansted, VI 00820

Mailing address

3004 Orange Grove
Christiansted, VI 00820
Phone (340) 201-3157

Other names 1

  • Plessen Medical Urgent Care Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aeast@plessenhealthcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160301000382 VI Part B Supplier - Clinic/Group Practice 8921303918 Receives reassigned benefits from 19 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Christiansted, VI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Plessen Medical Group LLC2 organizations share this tax ID, including this one
Part of
Plessen Medical Group LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1225639412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 ORANGE GROVE",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00820",
            "telephone_number": "340-201-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNNY ISLES SHOPPING CENTER",
            "address_2": "SPACE #1, 2, AND 3A",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00820",
            "telephone_number": "340-715-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLESSEN MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLESSEN MEDICAL GROUP, LLC",
        "enumeration_date": "2020-11-04",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "TAWAKOL",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-885-3917"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aeast@plessenhealthcare.com",
            "affiliation": "N",
            "address_1": "Sunny Isles Shopping Center",
            "address_2": "Space #1, 2, and 3A",
            "city": "Christiansted",
            "state": "VI",
            "country_code": "US",
            "postal_code": "00820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Plessen Medical Urgent Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Plessen Medical Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Christiansted, VI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.