Individual provider Active NPI

Jack Elliott Basse, MD

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1083300669
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1083300669 Issued in CA
Practice address
757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone
(310) 794-0785
NPI assigned
Apr 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1083300669 CA Primary

Addresses

Primary practice location

757 Westwood PLZ
Los Angeles, CA 90095-8358

Mailing address

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 794-0785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251203003872 CA Practitioner - Emergency Medicine 7618481664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Washington University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

7515 Van Nuys Blvd
Van Nuys, CA 91405-1949
Phone (818) 627-3050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince Aug 16, 2025 Accepting new patients
County of Los Angeles CurrentSince Aug 16, 2025 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1108 N Oleander Ave
Compton, CA 90222
Phone (310) 763-2244

123 W Manchester Blvd
Inglewood, CA 90301
Phone (310) 419-5325

7515 Van Nuys Blvd
Van Nuys, CA 91405
Phone (818) 627-3000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1083300669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-794-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958358",
            "telephone_number": "310-794-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSE",
        "first_name": "JACK",
        "middle_name": "ELLIOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "1083300669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.