NPIMap

Organization Active NPI

Samir Basata MD

  • Urology Physician
  • Burton, MI
National Provider Identifier
1093171191
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301057189 Issued in MI
Legal business name
SAMIR BASATA MD
Practice address
1501 S Center Rd
Building B
Burton, MI 48509-1731
Phone
(810) 742-3400
Fax
(810) 742-2534
NPI assigned
Jan 6, 2016
Last updated
Jan 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Dr. Samir Basata, MDNPI 1417069279
Title
Owner
Phone
(810) 742-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301057189 MI Primary

Addresses

Primary practice location

1501 S Center Rd
Building B
Burton, MI 48509-1731

Mailing address

1501 S Center Rd
Building B
Burton, MI 48509-1731
Phone (810) 742-3400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1093171191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD",
            "address_2": "BUILDING B",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-742-3400",
            "fax_number": "810-742-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD",
            "address_2": "BUILDING B",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-742-3400",
            "fax_number": "810-742-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMIR BASATA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "BASATA",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-742-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301057189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.