Individual provider Active NPI

Jason Norbert Wasche, DO

  • Family Medicine Physician
  • Watsonville, CA
National Provider Identifier
1376857409
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11163 Issued in CA
Practice address
550 S Green Valley Rd
Watsonville, CA 95076-3053
Phone
(831) 458-5865
Fax
(831) 458-5878
NPI assigned
Jul 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A11163 CA Primary

Addresses

Primary practice location

550 S Green Valley Rd
Watsonville, CA 95076-3053

Mailing address

2025 Soquel Ave
Santa Cruz, CA 95062-1323
Phone (831) 458-5865

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101201001266 CA Practitioner - Family Practice 6103012117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

325 Distel Cir
Los Altos, CA 94022-1408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A11163CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians Inc CurrentSince Jun 1, 2012 Accepting new patients
Addiction Research and Treatment, Inc. CurrentSince Apr 24, 2024 Accepting new patients
Janus of Santa Cruz CurrentSince Sep 19, 2022 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jun 1, 2012 Accepting new patients
Janus of Santa Cruz Past Accepting new patients

Locations

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

200 7th Ave
Ste 150
Santa Cruz, CA 95062
Phone (831) 423-9015

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 6

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": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1376857409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323",
            "telephone_number": "831-458-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S GREEN VALLEY RD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763053",
            "telephone_number": "831-458-5865",
            "fax_number": "831-458-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASCHE",
        "first_name": "JASON",
        "middle_name": "NORBERT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-30",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

Verify at the official NPI Registry.