Active NPI
Basem Jassin, M.D.
- Otolaryngology Physician
- Ennis, TX
National Provider Identifier
1336124130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- L3693
- Practice address
- 818 W Ennis Ave
Ennis, TX 75119-3810 - Phone
- (972) 875-9700
- Fax
- (972) 875-9721
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | L3693 | TX | Primary |
Addresses
Primary practice location
818 W Ennis Ave
Ennis, TX 75119-3810
Mailing address
818 W Ennis Ave
Ennis, TX 75119-3810
Phone (972) 875-9700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0047JG | Other | TX | BCBS IND # |
| 040017501 | Other | TX | RAILROAD MC |
| 153978501 | Medicaid | TX |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285113600000",
"number": "1336124130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "818 W ENNIS AVE",
"city": "ENNIS",
"state": "TX",
"postal_code": "751193810",
"telephone_number": "972-875-9700",
"fax_number": "972-875-9721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "818 W ENNIS AVE",
"city": "ENNIS",
"state": "TX",
"postal_code": "751193810",
"telephone_number": "972-875-9700",
"fax_number": "972-875-9721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASSIN",
"first_name": "BASEM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2010-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "TX",
"license": "L3693",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IND #",
"identifier": "0047JG",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MC",
"identifier": "040017501",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "153978501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ennis, TX
- Heather Rae Ivers, PHARM.D., R.PH.
- Jackson Services & Management LLC
- Erin Denise Jackson, LPC
- Ajaykumar R Jadeja, RPH
- Janie E. Roberson MD PA Dba North Texas Children's Clinic
- Jerry Northcutt, PLLC (Ellis County Eye Center)
- Jill Van Horn DO a Professional Corporation
- Larry A Jinks, MD
- Sanil Mathew John
- Margarita Rosendo Johnston, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.