Individual provider Active NPI

Victoria Basile, DO

  • Internal Medicine Physician
  • Trinity, FL
National Provider Identifier
1003559378
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
H0103510 Issued in MD
Practice address
9330 FL-54
Trinity, FL 34655
Phone
(727) 834-4000
NPI assigned
Apr 15, 2022
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H0103510 MD Primary

Addresses

Primary practice location

9330 FL-54
Trinity, FL 34655

Mailing address

2845 W Walnut St
Johnson City, TN 37604-6365
Phone (423) 946-6072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630000043 MD Practitioner - Internal Medicine 5799298253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mdics at Civista LLCGroup PAC ID 8325200793, 35 clinicians

Practice addresses (Care Compare)

5 Garrett Ave
La Plata, MD 20646-5960
Phone (443) 949-0814

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H0103510MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mdics at Civista LLC CurrentSince Jun 20, 2025 Accepting new patients
Thomas M. Kerr MD PA PastSince Apr 17, 2022 Accepting new patients
Civista Medical Center Inc Past Accepting new patients

Locations

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

Interoperability endpoints

  • Direct secure messaging: vbasile1276786@direct.umm.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1003559378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046365",
            "telephone_number": "423-946-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 FL-54",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "34655",
            "telephone_number": "727-834-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASILE",
        "first_name": "VICTORIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H0103510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

Verify at the official NPI Registry.