Michael D Jasso, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18645 Issued in CA

Practice address

16008 Kamana Rd
Ste 100
Apple Valley, CA 92307-1376

Phone

(760) 956-5200

Fax

(760) 669-0793

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mjasso1373339@oc.providencedirect.org
• Direct secure messaging: michaeljasso@rkkmdi.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anupama Sharma MD Inc

  dba Radiant Primary Care

  • Multi-Specialty Clinic/Center
  • Victorville, CA
  • NPI 1922212653
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Apple Valley, CA
  • NPI 1104871623
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Dignity Health

  dba St. Mary Medical Center

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1356404305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16008 KAMANA RD",
            "address_2": "STE 100",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071376",
            "telephone_number": "760-956-5200",
            "fax_number": "760-669-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16008 KAMANA RD",
            "address_2": "STE 100",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071376",
            "telephone_number": "760-956-5200",
            "fax_number": "760-669-0793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12550 Hesperia Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923955873",
            "country_code": "US",
            "telephone_number": "760-241-6666",
            "fax_number": "760-243-2099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASSO",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSCIAN ASSISTAN LIC",
            "identifier": "PA18645",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjasso1373339@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "18310 US Highway 18",
            "city": "Apple Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923072206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alden I Jallorina, M.D.
• Kathleen Patrice James, LCSW, MSW
• Shaan D James, BA
• Janardhana R Kolavala a Professional Corporation
• Kunal Rashmin Jardosh, M.D.
• Belinda Heredia Jauregui
• Ashwin Jayakumar, DO
• Marline F Jean-Louis, ARNP-BC
• Jeeva Healthcare Inc
• Rita T Jefferson

• Physician Assistant in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.