Active NPI
Asa Jude-Vassallo, PA-C
- Physician Assistant
- Troy, MI
National Provider Identifier
1659769032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601007242
- Practice address
- 1819 E Big Beaver Rd
Suite 210
Troy, MI 48083-2015 - Phone
- (248) 680-9000
- Fax
- (248) 680-2929
- NPI assigned
- Jan 7, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601007242 | MI | Primary |
Addresses
Primary practice location
1819 E Big Beaver Rd
Suite 210
Troy, MI 48083-2015
Mailing address
1819 E Big Beaver Rd
Suite 210
Troy, MI 48083-2015
Phone (248) 680-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601007242 | Other | MI | LICENSE |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601007242 | MI | MD | Physician Assistant |
Interoperability endpoints
- ajudevassallo361243@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436486400000",
"number": "1659769032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1819 E BIG BEAVER RD",
"address_2": "SUITE 210",
"city": "TROY",
"state": "MI",
"postal_code": "480832015",
"telephone_number": "248-680-9000",
"fax_number": "248-680-2929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1819 E BIG BEAVER RD",
"address_2": "SUITE 210",
"city": "TROY",
"state": "MI",
"postal_code": "480832015",
"telephone_number": "248-680-9000",
"fax_number": "248-680-2929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDE-VASSALLO",
"first_name": "ASA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-07",
"last_updated": "2015-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601007242",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "5601007242",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.