Jasen W Gundersen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

212168 Issued in MA

Practice address

119 Belmont St
Department of Family Hospital Medicine
Worcester, MA 01605-2903

Phone

(508) 334-5571

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• FL Pacs 2 PA

  • Hospitalist Physician
  • Ocala, FL
  • NPI 1184100612
  NPD (past) Authorized official
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Family Medicine

  NPD (past)
• Boca Medical Specialists, Inc

  • Hospitalist Physician
  • Tamarac, FL
  • NPI 1265453419

  Family Medicine

  NPD (past)
• Clinic Services of California Medical Group Inc

  • Emergency Medicine Physician
  • Lodi, CA
  • NPI 1578958450
  NPD (past)
• DHP of Twin Cities Medical Group Inc

  • Orthopaedic Surgery Physician
  • Templeton, CA
  • NPI 1295082857
  NPD (past)
• Hospital Medicine of California Inc

  • Hospitalist Physician
  • West Hills, CA
  • NPI 1770037236

  Family Medicine

  NPD (past)
• Quantum Bay Area Hospitalist Medical Group Inc

  • Hospitalist Physician
  • Mountain View, CA
  • NPI 1902279656
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1881677789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BELMONT ST",
            "address_2": "DEPARTMENT OF FAMILY HOSPITAL MEDICINE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052903",
            "telephone_number": "508-334-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "JASEN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "212168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192350",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avery Gulino
• Laura R Gull, PT
• Adrian Gumienny
• Dhivya Gunasekar
• Dishani Gunawardena, M.D.
• Jiaqi Guo
• Aanchal Gupta, MBBS
• Aarzoo Gupta
• Ish Gupta, D.O.
• Kanav Gupta

• Family Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.