Individual provider Active NPI

Michael Slava Bassanell, PHARM D

  • Pharmacist
  • Forest Hills, NY
National Provider Identifier
1235153628
Registry record updated Nov 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
049875 Issued in NY
Practice address
11253 Queens Blvd
Forest Hills, NY 11375-5554
Phone
(718) 575-9482
Fax
(718) 263-7742
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 049875 NY Primary

Addresses

Primary practice location

11253 Queens Blvd
Forest Hills, NY 11375-5554

Mailing address

6433 99TH St
Apt 1B
Rego Park, NY 11374-3563
Phone (718) 275-1949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
049875NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan RX Inc Current Accepting new patients
Satya Drug Corp Current Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228003200000",
    "number": "1235153628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6433 99TH ST",
            "address_2": "APT 1B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743563",
            "telephone_number": "718-275-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11253 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755554",
            "telephone_number": "718-575-9482",
            "fax_number": "718-263-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSANELL",
        "first_name": "MICHAEL",
        "middle_name": "SLAVA",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2008-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "049875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2008; 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.