Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Clarence Jason Vastine, FNP-C

Individual provider Family Nurse Practitioner · NPI 1902121379

Mr. Clarence Jason Vastine, FNP-C is a Nurse Practitioner in Goodyear, Arizona. Qualified in 2009, 17 years ago. Practices with Privia Medical Group Arizona, LLC, a 96-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
17
Licensed in
AZ
In the registry since
2010
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

13555 W McDowell Rd Ste 103
Goodyear, AZ 85395-2625
Phone: (623) 932-1157
Fax: (623) 935-1045
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP3558 (AZ)

Record details

NPI number1902121379
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedMarch 29, 2010
Last updated in NPPESAugust 1, 2024
Certification dateAugust 1, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Privia Medical Group Arizona, Llc — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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