Individual provider Active NPI

John Clint Lasiter, MD

  • Otolaryngology Physician
  • San Angelo, TX
National Provider Identifier
1891899076
Registry record updated Sep 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
N4538 Issued in TX
Practice address
4450 Sunset Dr
San Angelo, TX 76901-5611
Phone
(325) 658-1511
Fax
(325) 659-0180
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X N4538 TX Primary

Addresses

Primary practice location

4450 Sunset Dr
San Angelo, TX 76901-5611

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

Other identifiers 1

IdentifierTypeStateIssuer
8CG991OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100831000466 TX Practitioner - Otolaryngology 3870617640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Texas a & M University System, HSC, College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dora Roberts Rehabilitation CenterGroup PAC ID 0941285498, 114 clinicians
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

306 W 3Rd St
Big Spring, TX 79720-2429
Phone (432) 267-3806

4450 Sunset Dr
San Angelo, TX 76904
Phone (325) 747-1511

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N4538TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic Otolaryngology CurrentSince Jul 1, 2010 Accepting new patients

Locations

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

4450 Sunset Dr
San Angelo, TX 76901
Phone (325) 481-2286

Interoperability endpoints

  • Direct secure messaging: jlasiter6798@shannonhealth.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1891899076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511",
            "fax_number": "325-659-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 SUNSET DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769015611",
            "telephone_number": "325-658-1511",
            "fax_number": "325-659-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASITER",
        "first_name": "JOHN",
        "middle_name": "CLINT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "N4538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CG991",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.