Active NPI
Basant M Farghaly, M.D.
- Family Medicine Physician
- St Augustine, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME97900
- Practice address
- 3100 US Highway 1 S Ste 4
St Augustine, FL 32086-6310 - Phone
- (904) 810-8063
- Fax
- (904) 621-9230
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME97900 | FL | Primary |
Addresses
Primary practice location
3100 US Highway 1 S Ste 4
St Augustine, FL 32086-6310
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (904) 810-8063
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 278175100 | Medicaid | FL | |
| PW879 | Other | FL | MEDICARE HF |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Southern Illinois University School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3100 US Hwy 1 S
Suite 4
St Augustine, FL 32086-6310
Phone (770) 312-5226
Hospital & facility affiliations
- Bravery Home Healthcare
- Trilogy Home Healthcare
- Flagler Hospital
- AdventHealth Palm Coast
- Adventhealth Palm Coast Parkway
- Baptist Health Medical Center - Jacksonville
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.79 of 100
- Quality
- 86.5
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME97900 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group Florida, LLC | Current | Accepting new patients | |
| Omar Medical PLLC | Past | Accepting new patients |
Locations
140 6th Ave
Indialantic, FL 32903
Phone (321) 312-3501
3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771
989 Sebastian Blvd
Unit 3
Sebastian, FL 32958
Phone (727) 617-1777
3100 US Highway 1 S
Ste 4
St Augustine, FL 32086
Phone (904) 810-8063
9332 State Road 54
Ste 403
Trinity, FL 34655
Phone (727) 376-1536
Interoperability endpoints
- basant.farghaly.1@8042.direct.athenahealth.com
Organizations & group practices 2
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.
-
- General Practice Physician
- Indialantic, FL
- NPI 1700649043
-
- Specialist
- St Augustine, FL
- NPI 1346568532
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Palm Coast, FL
- NPI 1861102345
-
- Home Health Agency
- Jacksonville, FL
- NPI 1871529347
-
- Home Health Agency
- Saint Augustine, FL
- NPI 1619742657
-
- General Acute Care Hospital
- St Augustine, FL
- NPI 1144211020
-
- General Acute Care Hospital
- Palm Coast, FL
- NPI 1679678486
-
- General Acute Care Hospital
- Jacksonville, FL
- NPI 1578620449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1104945872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "904-810-8063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 US HIGHWAY 1 S STE 4",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320866310",
"telephone_number": "904-810-8063",
"fax_number": "904-621-9230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARGHALY",
"first_name": "BASANT",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2022-10-04",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME97900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "278175100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE HF",
"identifier": "PW879",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.