Individual provider Active NPI

Ian Bruce Hassin, D.O.

  • Family Medicine Physician
  • Park City, UT
National Provider Identifier
1396777876
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7686635-1204 Issued in UT
Practice address
3220 Daybreaker Dr
Park City, UT 84098-5838
Phone
(561) 389-1518
Fax
(435) 615-7316
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 91085 NV
Family Medicine Physician 207Q00000X 7686635-1204 UT Primary

Addresses

Primary practice location

3220 Daybreaker Dr
Park City, UT 84098-5838

Mailing address

3220 Daybreaker Dr
Park City, UT 84098-5838
Phone (561) 389-1518

Other names 1

  • Dr. Ian B Hassin Professional name

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 Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1085NVMDAddiction (Substance Use Disorder) Counselor
91085NVMDFamily Medicine Physician
7686635-1204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Medical Group Coats LTD Family Medicine Current Accepting new patients
Medical Specialists of the Palm Beaches Inc Family Medicine Past Accepting new patients

Locations

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

Organizations & group practices 2

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1396777876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 DAYBREAKER DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985838",
            "telephone_number": "561-389-1518",
            "fax_number": "435-615-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 DAYBREAKER DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985838",
            "telephone_number": "561-389-1518",
            "fax_number": "435-615-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSIN",
        "first_name": "IAN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "91085",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "7686635-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IAN",
            "last_name": "HASSIN",
            "middle_name": "B",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.