Provider Demographics
NPI:1831176486
Name:HASS, JASON G (PA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:G
Last Name:HASS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:NE
Mailing Address - Zip Code:68978-0407
Mailing Address - Country:US
Mailing Address - Phone:402-879-4781
Mailing Address - Fax:402-879-3365
Practice Address - Street 1:525 E 11TH ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:NE
Practice Address - Zip Code:68978-1101
Practice Address - Country:US
Practice Address - Phone:402-879-4781
Practice Address - Fax:402-879-3365
Is Sole Proprietor?:No
Enumeration Date:2005-12-26
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE0676363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE275908Medicare ID - Type Unspecified
NES20366Medicare UPIN