Lora J Van Tassel, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

50424 Issued in AZ

Practice address

3145 E Chandler Blvd Ste 110-109
Phoenix, AZ 85048-8702

Phone

(602) 935-9773

NPI assigned

Apr 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lora J Pittman Former name

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 24, 2025 through Apr 24, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FDGBAA

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.

• Desert Shores Pediatrics

  • Pediatrics Physician
  • Gilbert, AZ
  • NPI 1124386487
  NPD (past)

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1437417342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 E CHANDLER BLVD STE 110-109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488702",
            "telephone_number": "602-935-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 E CHANDLER BLVD STE 110-109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850488702",
            "telephone_number": "602-935-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSEL",
        "first_name": "LORA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "50424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORA",
            "last_name": "PITTMAN",
            "middle_name": "J",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott F Van Poppel, M.D.
• Linda Van Sande
• Noreen Ann Van Schil, PA
• Sally Van Snepson, PA
• Dane Van Tassel, MD
• Kimberly Van Wuffen, LPC
• Clinton Gerard Vanacker
• Nancy M Vanacore
• William Vanarsdell, MD
• Lisa Vanatta, MS, RDN, CSP

• Pediatrics Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.