Individual provider Active NPI

Jasmin Vasquez, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1891380317
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8850 Issued in AZ
Practice address
9930 W Indian School Rd
Phoenix, AZ 85037-5902
Phone
(623) 846-7558
NPI assigned
Mar 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8850 AZ Primary

Addresses

Primary practice location

9930 W Indian School Rd
Phoenix, AZ 85037-5902

Mailing address

530 N Thomas Rd
Phoenix, AZ 85012-3204
Phone (602) 422-9000

Other practice location 1

35 N Estrella Pkwy
Goodyear, AZ 85338-4690
Phone (623) 846-7558

Other names 1

  • Jasmin Betancourt Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20211222001654 AZ Practitioner - Physician Assistant 1951792118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona OB GYN Affiliates PCGroup PAC ID 7911094040, 122 clinicians

Practice addresses (Care Compare)

1950 W Frye Rd
Suite B
Chandler, AZ 85224-6255
Phone (480) 895-9555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8850AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona OB/GYN Affiliates PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jasmin.vasquez.1@14294.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14294/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1891380317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123204",
            "telephone_number": "602-422-9000",
            "fax_number": "602-556-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 W INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375902",
            "telephone_number": "623-846-7558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 N Estrella Pkwy",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853384690",
            "country_code": "US",
            "telephone_number": "623-846-7558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JASMIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-12-07",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMIN",
            "last_name": "BETANCOURT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.