Elise Noel Bascom, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3154 Issued in OR

Practice address

1551 Pearl St
Eugene, OR 97401-4010

Phone

(541) 517-9733

NPI assigned

Oct 23, 2019

Last updated

Feb 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sokyahealth Medical Group PCGroup PAC ID 9739575648, 68 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

• Direct secure messaging: elise.bascom.p1@direct.sokya.nextgenshare.com

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.

• Sokyahealth Medical Group PC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1447842232

  Psychologist

  Medicare reassignment Care Compare group NPD
• Vista Counseling & Consultation, Inc.

  • Community/Behavioral Health Agency
  • Eugene, OR
  • NPI 1275864985
  Medicare reassignment NPD

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1043853948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 PEARL ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014010",
            "telephone_number": "541-517-9733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PEARL ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014010",
            "telephone_number": "541-517-9733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCOM",
        "first_name": "ELISE",
        "middle_name": "NOEL",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Jackson Barton
• Jeannie Kolleen Bartram, LMT
• Anna Diane Bartuska
• Ashlynn Barwig
• Jennifer Barwood, RN
• Baseline Counseling
• Harriette L. Bashi, MS, PT
• Rachel Diane Basolo, BIRTH DOULA
• Ricki J Bass
• Jonathan Basso, MSOT

• Psychologist in Eugene, OR
• Providers in Eugene, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.