Organization Active NPI

Joseph S. Wassef, M.D., P.C.

  • Psychiatry Physician
  • Tyler, TX
National Provider Identifier
1578850145
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JOSEPH S. WASSEF, M.D., P.C.
Practice address
2010 Sybil LN Ste 150
Tyler, TX 75703-1830
Phone
(903) 504-5459
Fax
(903) 504-5460
NPI assigned
Jul 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Authorized official

Name
Dr. Joseph Soliman Wassef, M.D.NPI 1043233687
Title
Pyschiatrist
Phone
(903) 504-5459

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary
General Acute Care Hospital 282N00000X J2468 TX

Addresses

Primary practice location

2010 Sybil LN Ste 150
Tyler, TX 75703-1830

Mailing address

2010 Sybil LN Ste 150
Tyler, TX 75703-1830
Phone (903) 504-5459

Other practice location 1

3400 W Marshall Ave
Suite 426
Longview, TX 75604-5059
Phone (903) 758-4292

Other identifiers 3

IdentifierTypeStateIssuer
061730OtherVALUE OPTIONS
5295014OtherTXAETNA
00T73HOtherBLUE CROSS AND BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110808000265 TX Part B Supplier - Clinic/Group Practice 9032388178 Receives reassigned benefits from 1 practitioner
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

3400 W Marshall Ave
Ste 426
Longview, TX 75604
Phone (903) 758-4292

1021 E Southeast Loop 323
Ste 370
Tyler, TX 75701
Phone (903) 504-5459

2010 Sybil Ln
Ste 150
Tyler, TX 75703
Phone (903) 504-5459

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1578850145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN STE 150",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031830",
            "telephone_number": "903-504-5459",
            "fax_number": "903-504-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 SYBIL LN STE 150",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031830",
            "telephone_number": "903-504-5459",
            "fax_number": "903-504-5460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 W Marshall Ave",
            "address_2": "Suite 426",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756045059",
            "country_code": "US",
            "telephone_number": "903-758-4292",
            "fax_number": "903-758-6055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOSEPH S. WASSEF, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "WASSEF",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "SOLIMAN",
        "authorized_official_title_or_position": "PYSCHIATRIST",
        "authorized_official_telephone_number": "903-504-5459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "J2468",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE  OPTIONS",
            "identifier": "061730",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5295014",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "00T73H",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.