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NPI Code Detail

MEDICARE: DR. JEFFREY BASA M.D.

MEDICARE:  DR. JEFFREY  BASA  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician8079NV
22081H0002XHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician8079NV
3207R00000XInternal Medicine Physician8079NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3110218907OTHERNVRAILROAD MEDICARE #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NV0116OTHERNVBCBS PROVIDER #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992851323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY BASA M.D.
Provider Business Mailing Address
First Line : PO BOX 4540
Second Line :
City : CARSON CITY
State : NV
Zip : 89702-4540
Country : US
Telephone Number : 775-445-7170
Fax Number : 775-883-0959
Provider Business Practice Location Address
First Line : 2874 N CARSON ST
Second Line : SUITE 200
City : CARSON CITY
State : NV
Zip : 89706-0251
Country : US
Telephone Number : 775-445-7170
Fax Number : 775-883-0959
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 01/11/2023

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Directions to “ DR. JEFFREY BASA M.D.” Practice Location

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