Individual provider Active NPI

Patrick Basu, M.D.

  • Gastroenterology Physician
  • Orlando, FL
National Provider Identifier
1053396572
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME135670 Issued in FL
Practice address
6735 Conroy Rd Ste 223
Orlando, FL 32835-3570
Phone
(407) 203-2377
Fax
(407) 203-8811
NPI assigned
Dec 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 51337 KY
Gastroenterology Physician 207RG0100X 190318 NY
Transplant Hepatology Physician 207RT0003X ME135670 FL
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X ME135670 FL Primary
Hepatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0008X ME135670 FL
Hepatology Physician 207RI0008X 190318 NY

Addresses

Primary practice location

6735 Conroy Rd Ste 223
Orlando, FL 32835-3570

Mailing address

9534 Wickham Way
Orlando, FL 32836-5524
Phone (917) 226-0284

Other practice location 1

5 Station Sq
Forest Hills, NY 11375-5232
Phone (718) 897-0584

Other practice location 2

6735 Conroy Rd Ste 223
Orlando, FL 32835-3570
Phone (407) 801-5248

Other identifiers 13

IdentifierTypeStateIssuer
166115OtherELDERPLAN
218509OtherWELLCARE
2499388OtherGHI PPO
5044440OtherNYAETNA
HEALTH NETOther4C2929
693723OtherFIRST HEALTH
76220OtherGHI HMO
190318A33OtherHEALTH FIRST
60H103OtherNYBCBS
111517OtherVYTRA
1424916OtherUNITED HEALTH CARE
P627420OtherOXFORD HP
09659POtherNYHIP OF NY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY, CO, NM4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20180820000775 FL Practitioner - Gastroenterology 0143260646
I20200110002114 KY Practitioner - Gastroenterology 0143260646 Reassigns benefits to 1 organization
I20231211001411 CO Practitioner - Internal MedicinePractitioner - Gastroenterology 0143260646 Reassigns benefits to 1 organization
I20240822001952 NM Practitioner - Gastroenterology 0143260646 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.05 of 100Reported as group
Quality
84.23
Promoting interoperability
100
Improvement activities
40
Cost
51.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME135670FLMDHepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Surgical Network Inc. Multi-Specialty CurrentSince Dec 1, 2023 Accepting new patients
Trinidad Area Health Association Multi-Specialty CurrentSince Nov 13, 2023 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC Multi-Specialty CurrentSince Sep 1, 2020 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Trinidad Area Health Association Multi-Specialty CurrentSince Nov 13, 2023 Accepting new patients
Las Cruces Physician Services LLC Multi-Specialty CurrentSince Jun 9, 2024 Accepting new patients
Familycare Associates,PA Multi-Specialty Past Accepting new patients
Vitality Integrated Medical Network LLC Multi-Specialty PastSince Dec 24, 2023 Accepting new patients
Michael Z Weiner MDPC Multi-Specialty Past Accepting new patients

Locations

400 Benedicta Ave
Ste A
Trinidad, CO 81082
Phone (719) 846-2206

410 Benedicta Ave
Trinidad, CO 81082
Phone (719) 846-8051

13845 US Highway 1
Sebastian, FL 32958
Phone (772) 589-9071

275 18th St
Ste 102
Vero Beach, FL 32960
Phone (772) 559-9998

225 Medical Center Dr
Ste 308
Paducah, KY 42003
Phone (270) 441-4750

1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

1135 S Main St
Ste B
Las Cruces, NM 88005
Phone (505) 522-5205

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: patrick.basu.1@5071.direct.athenahealth.com

Organizations & group practices 10

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1053396572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9534 WICKHAM WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365524",
            "telephone_number": "917-226-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 CONROY RD STE 223",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353570",
            "telephone_number": "407-203-2377",
            "fax_number": "407-203-8811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Station Sq",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113755232",
            "country_code": "US",
            "telephone_number": "718-897-0584",
            "fax_number": "718-896-5571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6735 Conroy Rd Ste 223",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328353570",
            "country_code": "US",
            "telephone_number": "407-801-5248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASU",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "51337",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "190318",
            "primary": false
        },
        {
            "code": "207RT0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Transplant Hepatology",
            "state": "FL",
            "license": "ME135670",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME135670",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hepatology",
            "state": "FL",
            "license": "ME135670",
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "NY",
            "license": "190318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELDERPLAN",
            "identifier": "166115",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "218509",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO",
            "identifier": "2499388",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5044440",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "4C2929",
            "identifier": "HEALTH NET",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "693723",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "76220",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH FIRST",
            "identifier": "190318A33",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60H103",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "111517",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1424916",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HP",
            "identifier": "P627420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP OF NY",
            "identifier": "09659P",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.