Edward Robert Wassman Jr., M.D.

Primary specialty

Clinical Molecular Genetics PhysicianTaxonomy code 207SG0203X

License

DRN2 Issued in CA

Practice address

7482 Pinebrook Rd
Park City, UT 84098-5346

Phone

(562) 500-5197

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Sep 8, 2022 through Sep 8, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1396966735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7482 PINEBROOK RD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985346",
            "telephone_number": "562-500-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7482 PINEBROOK RD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985346",
            "telephone_number": "562-500-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSMAN",
        "first_name": "EDWARD",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "NY",
            "license": "135000",
            "primary": false
        },
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "CA",
            "license": "DRNM10",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "G040633",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CT",
            "license": "41719",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "FL",
            "license": "ME80666",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "30741",
            "primary": false
        },
        {
            "code": "207SG0203X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Molecular Genetics",
            "state": "CA",
            "license": "DRN2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Warcup
• Wasatch Crest Treatment Services
• Wasatch NP House Calls LLC
• Wasatch Physical Therapy & Sports Medicine at Park City
• Wasatch Psychological Consultants
• Michael Watkins
• Jan Watts, PT
• We Healthy LLC
• Shannon Weaver, LCSW
• Leslie Worthen Webster, MD

• Clinical Molecular Genetics Physician in Park City, UT
• Providers in Park City, UT by specialty
• Clinical Molecular Genetics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.