Individual provider Active NPI

Joseph A. Gassen, M.D.

  • Pediatrics Physician
  • Mesa, AZ
National Provider Identifier
1972586006
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
47682 Issued in AZ
Practice address
5131 E Southern Ave
Mesa, AZ 85206-2799
Phone
(480) 833-5437
Fax
(480) 833-9349
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 18975 MS
Hospitalist Physician 208M00000X 18975 MS
Pediatrics Physician 208000000X 47682 AZ Primary

Addresses

Primary practice location

5131 E Southern Ave
Mesa, AZ 85206-2799

Mailing address

1919 E Thomas Rd BLDG 2108
101
Phoenix, AZ 85016-7710
Phone (602) 512-8029

Other identifiers 2

IdentifierTypeStateIssuer
009932953MedicaidAL
04150085MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20060313000479 NV Practitioner - Pediatric Medicine 5698709640 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47682AZMDPediatrics Physician
18975MSMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brown, Calvanese, Cameron LTD CurrentSince Jul 1, 2016 Accepting new patients
Phoenix Children'S Hospital Hope Past Accepting new patients

Locations

1155 Mill St
Reno, NV 89502
Phone (775) 982-7878

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1972586006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD BLDG 2108",
            "address_2": "101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-512-8029",
            "fax_number": "602-512-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062799",
            "telephone_number": "480-833-5437",
            "fax_number": "480-833-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASSEN",
        "first_name": "JOSEPH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "18975",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MS",
            "license": "18975",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "47682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932953",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04150085",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.