Active NPI
Ian Bruce Hassin, D.O.
- Family Medicine Physician
- Park City, UT
National Provider Identifier
1396777876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 7686635-1204
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1085 | NV | MD | Addiction (Substance Use Disorder) Counselor |
| 91085 | NV | MD | Family Medicine Physician |
| 7686635-1204 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Family Medicine Physician
- Las Vegas, NV
- NPI 1487631917
-
- Internal Medicine Physician
- Boynton Beach, FL
- NPI 1740343615
Family Medicine
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.