Individual provider Active NPI

Patrick Sassoon, M.D.

  • Psychiatry Physician
  • Vail, CO
National Provider Identifier
1578726642
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DR.0064453 Issued in CO
Practice address
395 E Lionshead Cir
Vail, CO 81657-5354
Phone
(970) 476-0930
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9185 FL
Professional Counselor 101YP2500X 4441 CO
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X DR.0064453 CO Primary

Addresses

Primary practice location

395 E Lionshead Cir
Vail, CO 81657-5354

Mailing address

21515 Hawthorne Blvd Ste 200
Torrance, CA 90503-6512
Phone (720) 212-1222

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 Medicine

State licenses

LicenseStateTypeSpecialty
4441COMDProfessional Counselor
9185FLMDChiropractor
DR.0064453COMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sassoon Psychiatric Services, P.C. Psychiatry Current Accepting new patients
Kamala Thomas Psychological Services Corp PastSince Dec 5, 2020 Accepting new patients

Locations

21515 Hawthorne Blvd
Ste 200
Torrance, CA 90503
Phone (310) 371-7984

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1578726642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21515 HAWTHORNE BLVD STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036512",
            "telephone_number": "720-212-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 E LIONSHEAD CIR",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575354",
            "telephone_number": "970-476-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASSOON",
        "first_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "9185",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "4441",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0064453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vail, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.