Healthcare Provider Details

I. General information

NPI: 1194957589
Provider Name (Legal Business Name): JASON KASS MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SUMMER ST STE 300
WORCESTER MA
01608-1216
US

IV. Provider business mailing address

123 SUMMER ST STE 300
WORCESTER MA
01608-1216
US

V. Phone/Fax

Practice location:
  • Phone: 508-368-3103
  • Fax: 508-368-3104
Mailing address:
  • Phone: 508-368-3103
  • Fax: 508-368-3104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number263693
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: