NPIMap

Individual provider Active NPI

Dane Van Tassel, MD

  • Pediatric Radiology Physician
  • Phoenix, AZ
National Provider Identifier
1376805044
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
48187 Issued in AZ
Practice address
2929 E Thomas Rd
Phoenix, AZ 85016
Phone
(602) 470-5000
Fax
(602) 933-1214
NPI assigned
Jun 8, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R73452 AZ
Diagnostic Radiology Physician 2085R0202X 48187 AZ
Pediatric Radiology Physician 2085P0229X 48187 AZ Primary

Addresses

Primary practice location

2929 E Thomas Rd
Phoenix, AZ 85016

Mailing address

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-3540

Other identifiers 1

IdentifierTypeStateIssuer
R73452OtherAZTRAINING PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004002967 AZ Practitioner - Diagnostic Radiology 7214202043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arizona College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
District Medical Group IncGroup PAC ID 7315086691, 454 clinicians

Practice addresses (Care Compare)

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

3141 N 3Rd Ave
Phoenix, AZ 85013-4360
Phone (602) 914-1520

Hospital & facility affiliations

  • Valleywise Health Medical Center Hospital, Phoenix, AZ, CCN 030022

Merit-based Incentive Payment System (MIPS)

Final score
95.59 of 100Reported as group
Quality
81.55
Promoting interoperability
100
Improvement activities
40
Cost
79.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R73452AZMDInternal Medicine Physician
48187AZMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Aug 26, 2017 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Oct 1, 2018 Accepting new patients
Phoenix Children'S Hospital Current Accepting new patients
District Medical Group, Inc CurrentSince Aug 26, 2017 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Oct 1, 2018 Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients

Locations

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

19007 N 67th Ave
Glendale, AZ 85308
Phone (602) 933-0777

6524 W Sack Dr
Ste 130
Glendale, AZ 85308

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

3141 N 3rd Ave
Ste 100
Phoenix, AZ 85013
Phone (602) 914-1520

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

Interoperability endpoints

  • Direct secure messaging: dvantassel20484@direct.valleywisehealth.org

Organizations & group practices 7

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1376805044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-3540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "602-470-5000",
            "fax_number": "602-933-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSEL",
        "first_name": "DANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R73452",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "48187",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "AZ",
            "license": "48187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R73452",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.