NPIMap

Individual provider Active NPI

Basil Colin Hamblin, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Point Reyes Station, CA
National Provider Identifier
1114095106
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
A76893 Issued in CA
Practice address
11150 State Route One
Point Reyes Station, CA 94956
Phone
(415) 663-8666
NPI assigned
Nov 30, 2006
Last updated
Nov 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A76893 CA
Geriatric Medicine (Family Medicine) Physician 207QG0300X A76893 CA Primary

Addresses

Primary practice location

11150 State Route One
Point Reyes Station, CA 94956

Mailing address

PO Box 240
11150 State Route One
Point Reyes Station, CA 94956
Phone (415) 663-8666

Other identifiers 1

IdentifierTypeStateIssuer
00A768930MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000733 CA Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 7810969458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine, Hospice/Palliative Care
Education
University of Rochester School of Medicine and Dentistry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11150 Route 1
Point Reyes Station, CA 94956
Phone (415) 663-1082

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colin Hamblin, a Professional Medical Corporation Family Medicine CurrentSince Nov 1, 2012 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
Marin General Hospital Past Accepting new patients
San Rafael Operating Company LP Past Accepting new patients
Sonoma Valley Health Care District Past Accepting new patients
SRM Alliance Hospital Services Past Accepting new patients

Locations

11150 Highway 1
Pt Reyes Sta, CA 94956
Phone (415) 663-1082

Interoperability endpoints

  • Direct secure messaging: basilhamblin@chapmc.allscriptsdirect.net
  • Direct secure messaging: bhamblin1705142@oc.providencedirect.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sutter Care at HomeSanta Rosa, CA, CCN 051761 Hospice Contracted Managing Employee
Operational/Managerial Control		 Apr 23, 2018
Apr 23, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1114095106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240",
            "address_2": "11150 STATE ROUTE ONE",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "94956",
            "telephone_number": "415-663-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 STATE ROUTE ONE",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "94956",
            "telephone_number": "415-663-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLIN",
        "first_name": "BASIL",
        "middle_name": "COLIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76893",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A76893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A768930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Reyes Station, CA

Sources for this page

Verify at the official NPI Registry.