Individual provider Active NPI

Jaclyn Ann Bassett, PA-C

  • Physician Assistant
  • West Des Moines, IA
National Provider Identifier
1740766658
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
125134 Issued in IA
Practice address
1525 Grand Ave
West Des Moines, IA 50265-3442
Phone
(515) 226-0112
Fax
(515) 223-0422
NPI assigned
Jul 13, 2018
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CO
Physician Assistant 363A00000X 125134 IA Primary
Medical Physician Assistant 363AM0700X PA.0005433 CO

Addresses

Primary practice location

1525 Grand Ave
West Des Moines, IA 50265-3442

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 226-0112

Other practice location 1

8080 Park Meadows Dr Ste 100
Lone Tree, CO 80124
Phone (303) 346-8828

Other practice location 2

8080 Park Meadows Dr Ste 100
Lone Tree, CO 80124
Phone (303) 346-8828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014004273 IA Practitioner - Physician Assistant 9537584941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

1525 Grand Ave
West Des Moines, IA 50265-3412
Phone (515) 226-0112

1601 NW 114TH St
Clive, IA 50325-7036

307 E Scenic Valley Ave
Indianola, IA 50125-4865

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
125134IAMDPhysician Assistant
PA.0005433COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc CurrentSince Sep 3, 2024 Accepting new patients
Mercy Clinics, Inc. CurrentSince Sep 3, 2024 Accepting new patients

Locations

1601 NW 114th St
Ste 247
Des Moines, IA 50325
Phone (515) 222-7000

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

1525 Grand Ave
West Des Moines, IA 50265
Phone (515) 226-0112

Interoperability endpoints

  • Direct secure messaging: jbassett3939414@direct.trinity-health.org

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1740766658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-226-0112",
            "fax_number": "515-223-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 GRAND AVE",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653442",
            "telephone_number": "515-226-0112",
            "fax_number": "515-223-0422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8080 Park Meadows Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "80124",
            "country_code": "US",
            "telephone_number": "303-346-8828",
            "fax_number": "303-346-0407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8080 Park Meadows Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "80124",
            "country_code": "US",
            "telephone_number": "303-346-8828",
            "fax_number": "303-346-0407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "JACLYN",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "125134",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0005433",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.