Individual provider Active NPI

Jasmin Ghasemloian, DO

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1275117657
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U9929 Issued in TX
Practice address
3095 Kingswood Blvd Ste 250
Grand Prairie, TX 75052-4502
Phone
(972) 817-8195
NPI assigned
May 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X U9929 TX Primary

Addresses

Primary practice location

3095 Kingswood Blvd Ste 250
Grand Prairie, TX 75052-4502

Mailing address

3095 Kingswood Blvd Ste 250
Grand Prairie, TX 75052-4502
Phone (972) 817-8195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240828005274 TX Practitioner - Family Practice 8022557461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3095 Kingswood Blvd
Suite 250
Grand Prairie, TX 75052-4502
Phone (972) 817-1950

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 1, 2024 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

3095 Kingswood Blvd
Ste 250
Grand Prairie, TX 75052
Phone 2143582300 ext. 6225

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

1005 Legacy Ranch Rd
Ste 100
Waxahachie, TX 75165
Phone (469) 800-5570

Interoperability endpoints

  • Direct secure messaging: jghasemloian1348055@direct.sw.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1275117657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KINGSWOOD BLVD STE 250",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524502",
            "telephone_number": "972-817-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KINGSWOOD BLVD STE 250",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524502",
            "telephone_number": "972-817-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHASEMLOIAN",
        "first_name": "JASMIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U9929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.