Individual provider Active NPI

Jennifer Paige Bassiur, D.D.S.

  • Orofacial Pain Dentistry
  • Woodmere, NY
National Provider Identifier
1043302151
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
051187 Issued in NY
Practice address
999 Central Ave Ste 103
Woodmere, NY 11598-1205
Phone
(866) 987-6673
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 051187 NY
Orofacial Pain Dentistry 1223X2210X 051187 NY Primary

Addresses

Primary practice location

999 Central Ave Ste 103
Woodmere, NY 11598-1205

Mailing address

1841 Mamie Dyer LN
Vienna, VA 22182-3400
Phone (917) 696-9325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060314000258 NY Practitioner - Oral SurgeryPractitioner - Interventional Pain Management 6305853532 Reassigns benefits to 1 organization
Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2017 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Sep 1, 2017 Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients
Oral Maxilofacial and Dental Pain Managment Past Accepting new patients

Locations

630 W 168th St
Rm 250
New York, NY 10032
Phone (212) 305-7626

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
Fl 3
New York, NY 10032
Phone (953) 521-2305

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#7226
New York, NY 10032
Phone (212) 305-8516

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1043302151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 MAMIE DYER LN",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823400",
            "telephone_number": "917-696-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 CENTRAL AVE STE 103",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981205",
            "telephone_number": "866-987-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSIUR",
        "first_name": "JENNIFER",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051187",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "NY",
            "license": "051187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, NY

Sources for this page

Verify at the official NPI Registry.