Active NPI
Joseph A. Gassen, M.D.
- Pediatrics Physician
- Mesa, AZ
National Provider Identifier
1972586006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 47682
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009932953 | Medicaid | AL | |
| 04150085 | Medicaid | MS |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47682 | AZ | MD | Pediatrics Physician |
| 18975 | MS | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brown, Calvanese, Cameron LTD | Current | 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.
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-
- Neonatal-Perinatal Medicine Physician
- Las Vegas, NV
- NPI 1992809412
-
- Pharmacy
- Phoenix, AZ
- NPI 1386749836
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.