Jack Oliver Wasey, MA MSCI MSC BM BCH

Primary specialty

Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X

License

MD457791 Issued in PA

Practice address

3401 Civic Center Blvd
Suite 9329
Philadelphia, PA 19104-4319

Phone

(180) 087-9246

NPI assigned

Jun 28, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children'S Anesthesiology Associates, LTD

  • Pediatric Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1689779480
  Medicare reassignment NPD
• Children'S Anesthesiology Associates, LTD

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1942213525
  NPD

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1831485804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "SUITE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1858",
            "fax_number": "267-425-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "SUITE 9329",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "180-087-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASEY",
        "first_name": "JACK",
        "middle_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "MA MSCI MSC BM BCH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-28",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MT207967",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT207967",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD457791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Rae Wartman, NP
• Raafeh Waseem
• Syed Waseem
• Nooshin Waseh, M.D.
• Shayan Waseh, MD
• Yasmine Sadiq Wasfi, M.D.
• Sean Washek
• Brianna Washington Banks
• Washington Investment Team, LLC
• Washington Square Chiropractic Center, L.L.C.

• Pediatric Anesthesiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Anesthesiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.

Verify at the official NPI Registry.