Active NPI
Michael Wasmundt, PA-C
- Medical Physician Assistant
- Mesa, AZ
National Provider Identifier
1598066060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 4746
- Practice address
- 1301 S Crismon Rd
Mesa, AZ 85209-3767 - Phone
- (480) 358-6100
- NPI assigned
- Nov 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 4746 | AZ | Primary |
Addresses
Primary practice location
1301 S Crismon Rd
Mesa, AZ 85209-3767
Mailing address
6052 W Irma LN
Glendale, AZ 85308-6749
Phone (480) 560-9648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America-Arizona, PC | Current | Accepting new patients | |
| Arizona Post-Acute Medical Services 1 PC | Past | Accepting new patients |
Locations
10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690
14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
Organizations & group practices 6
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.
-
- Hospitalist Physician
- Phoenix, AZ
- NPI 1154860674
-
- Emergency Medicine Physician
- Chandler, AZ
- NPI 1780202804
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1215275433
-
- Emergency Medicine Physician
- Glendale, AZ
- NPI 1285655209
-
- Hospitalist Physician
- Phoenix, AZ
- NPI 1093254419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1598066060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6052 W IRMA LN",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086749",
"telephone_number": "480-560-9648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 S CRISMON RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852093767",
"telephone_number": "480-358-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASMUNDT",
"first_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-15",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "4746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.