Individual provider Active NPI

Richard A Rasmussen Jr., D.D.S.

  • Periodontics
  • Tampa, FL
National Provider Identifier
1326103680
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DN9123 Issued in FL
Practice address
3450 E Fletcher Ave
Suite 340
Tampa, FL 33613-4655
Phone
(813) 977-2928
Fax
(813) 977-1494
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DN9123 FL Primary

Addresses

Primary practice location

3450 E Fletcher Ave
Suite 340
Tampa, FL 33613-4655

Mailing address

3450 E Fletcher Ave
Suite 340
Tampa, FL 33613-4655
Phone (813) 977-2928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180417003083 FL Order and Referring Only - DentistPractitioner - Dentist 7810250206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN9123FLMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard a. Rasmussen, DDS, PA Periodontics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326103680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 E FLETCHER AVE",
            "address_2": "SUITE 340",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134655",
            "telephone_number": "813-977-2928",
            "fax_number": "813-977-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E FLETCHER AVE",
            "address_2": "SUITE 340",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134655",
            "telephone_number": "813-977-2928",
            "fax_number": "813-977-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASMUSSEN",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN9123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.