Individual provider Active NPI

Bruce Parsa, D.O.

  • Psychiatry Physician
  • Saint Joseph, MO
National Provider Identifier
1639467764
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
106185 Issued in MO
Practice address
3505 Frederick Ave
Saint Joseph, MO 64506-2914
Phone
(816) 387-2300
NPI assigned
Jul 11, 2011
Last updated
Dec 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 106185 MO Primary

Addresses

Primary practice location

3505 Frederick Ave
Saint Joseph, MO 64506-2914

Mailing address

3505 Frederick Ave
Saint Joseph, MO 64506-2914
Phone (816) 387-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191119000058 MO Practitioner - Psychiatry 0042642712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri Psychiatry CurrentSince Nov 1, 2019 Accepting new patients
State of Missouri Psychiatry CurrentSince Nov 1, 2019 Accepting new patients
State of Missouri Psychiatry Current Accepting new patients

Locations

3505 Frederick Ave
Saint Joseph, MO 64506
Phone (816) 387-2300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1639467764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062914",
            "telephone_number": "816-387-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 FREDERICK AVE",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062914",
            "telephone_number": "816-387-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARSA",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "106185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.