Individual provider Active NPI

Joel D Jasa, P.A.-C.

  • Physician Assistant
  • Grand Island, NE
National Provider Identifier
1982923868
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1856 Issued in NE
Practice address
620 N Diers Ave
Ste. 200
Grand Island, NE 68803-4984
Phone
(308) 384-5400
Fax
(308) 384-5201
NPI assigned
May 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MN
Physician Assistant 363A00000X 1856 NE Primary

Addresses

Primary practice location

620 N Diers Ave
Ste. 200
Grand Island, NE 68803-4984

Mailing address

620 N Diers Ave
Ste. 200
Grand Island, NE 68803-4984
Phone (308) 384-5400

Other identifiers 1

IdentifierTypeStateIssuer
47054564512MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20141031000814 NE Practitioner - Physician Assistant 5799818639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Nebraska Orthopedics and Sports Medicine PCGroup PAC ID 8123077518, 13 clinicians

Practice addresses (Care Compare)

1423 7TH St
Aurora, NE 68818-1141
Phone (402) 694-3171

2620 W Faidley Ave
Grand Island, NE 68803-4205
Phone (308) 384-4600

620 N Diers Ave
Grand Island, NE 68803-4984
Phone (308) 384-5400

620 N Diers Ave
Suite 200
Grand Island, NE 68803-4985

715 N Saint Joseph Ave
Hastings, NE 68901-4451
Phone (402) 463-4521

Hospital & facility affiliations

  • Grand Island Regional Medical Center Hospital, Grand Island, NE, CCN 280139
  • CHI Health St. Francis Hospital, Grand Island, NE, CCN 280023
  • Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032
  • Memorial Hospital Hospital, Aurora, NE, CCN 281320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1856NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Clinic of Central Nebraska PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: joel.jasapac.d1.p1@direct.cnorthopedics.nextgenshare.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 5

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1982923868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N DIERS AVE",
            "address_2": "STE. 200",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034984",
            "telephone_number": "308-384-5400",
            "fax_number": "308-384-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N DIERS AVE",
            "address_2": "STE. 200",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034984",
            "telephone_number": "308-384-5400",
            "fax_number": "308-384-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASA",
        "first_name": "JOEL",
        "middle_name": "D",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47054564512",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

Verify at the official NPI Registry.