Regency Reconstruction PLLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

REGENCY RECONSTRUCTION PLLC

Practice address

3172 N Swan Rd
Tucson, AZ 85712-1227

Phone

(623) 243-9077

NPI assigned

Feb 22, 2021

Last updated

Feb 22, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

REGENCY RECONSTRUCTION PLLCAs reported in NPPES

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

Authorized official

Name

Jason Mussman, MDNPI 1144430182

Title

Provider/Owner

Phone

(989) 255-4794

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Part of

Regency Reconstruction PLLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Regency Reconstruction PLLC

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
  • NPI 1972086924
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Lee Mussman, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
  • NPI 1144430182
  NPD (past) Authorized official

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1568056570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD STE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375905",
            "telephone_number": "623-243-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3172 N SWAN RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857121227",
            "telephone_number": "623-243-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY RECONSTRUCTION PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENCY RECONSTRUCTION PLLC",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "MUSSMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "989-255-4794",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444652",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Office",
            "affiliation": "N",
            "address_1": "3172 N Swan Rd",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857121227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Plastic and Reconstructive Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.