Mark T Bastan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT02008 Issued in RI

Practice address

535 Centerville Rd
Suite 101
Warwick, RI 02886-4376

Phone

(401) 737-4581

Fax

(401) 737-6152

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Physical Therapy LLCGroup PAC ID 1951295187, 73 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Elite Physical Therapy, LLC

  • Physical Therapist
  • Warwick, RI
  • NPI 1225123565
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124139936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 CENTERVILLE RD",
            "address_2": "SUITE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864376",
            "telephone_number": "401-737-4581",
            "fax_number": "401-737-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CENTERVILLE RD",
            "address_2": "SUITE 101",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864376",
            "telephone_number": "401-737-4581",
            "fax_number": "401-737-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTAN",
        "first_name": "MARK",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "29806-7",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "27877",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "413078",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven J Barter, MA
• Nicole Blaze Barton, PA-C
• Delaney Basilios, PA-C
• Aditi Basnet, MD
• Ashley Bassett, LMHC
• Yasmin Bata, DO
• Stephanie Batista, PSYD
• Tarshire Battle, PC
• Jessica Lynn Baulier, BA
• Robert Edward Baute, M.D.

• All providers in Warwick, RI
• Physical Therapist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.