Individual provider Active NPI

Waseem Gazale, MD

  • Family Medicine Physician
  • Springfield, MO
National Provider Identifier
1235611161
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2018017320 Issued in MO
Practice address
3259 E Sunshine St Ste Aa
Springfield, MO 65804-2114
Phone
(619) 504-6362
NPI assigned
Sep 6, 2018
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2018017320 MO
Family Medicine Physician 207Q00000X 2018017320 MO Primary

Addresses

Primary practice location

3259 E Sunshine St Ste Aa
Springfield, MO 65804-2114

Mailing address

237 Steury Rd
Springfield, MO 65809-2416

Other practice location 1

1140 W Highway 76
Branson, MO 65616-2238
Phone (619) 504-6362

Other practice location 2

5571 N 21st St
Ozark, MO 65721-7488
Phone (619) 504-6362

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018017320MOMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1235611161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 STEURY RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658092416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3259 E SUNSHINE ST STE AA",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042114",
            "telephone_number": "619-504-6362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1140 W Highway 76",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162238",
            "country_code": "US",
            "telephone_number": "619-504-6362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5571 N 21st St",
            "address_purpose": "LOCATION",
            "city": "Ozark",
            "state": "MO",
            "postal_code": "657217488",
            "country_code": "US",
            "telephone_number": "619-504-6362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAZALE",
        "first_name": "WASEEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-06",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2018017320",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018017320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.