Basil Manly Griffin III, M.D.
Individual provider Active NPI Family Medicine Physician · Deer Park, WA
NPI 1245206358 · NPPES record last updated Aug 17, 2011
Key facts
- NPI
- 1245206358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 22640 (SC)
- Practice address
- 23 E. Crawford Ave.
Deer Park, WA 99006-5024 - Phone
- (509) 276-2554
- Fax
- (509) 276-2564
- NPI assigned
- Feb 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
23 E Crawford St
Deer Park, WA 99006-5002
Phone (509) 276-2554
Hospital & facility affiliations
- Hospice of Spokane
- Prov Sacred HRT Med Ctr & Childs Hosp.
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 13 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080825000117 | WA | Practitioner - Family Practice | 4183799224 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22640 | SC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chattaroy Family Medicine PLLC | Family Medicine | Current |
Accepting new patients |
| Deer Park Urgent Care PLLC | Family Medicine | Past | Accepting new patients |
Locations
23 E Crawford St
Deer Park, WA 99006
Phone (509) 276-2554
Interoperability endpoints
- basil.griffin.1@22080.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 22640 | SC | Yes |
Addresses
Primary practice location
23 E. Crawford Ave.
Deer Park, WA 99006-5024
Mailing address
PO Box 1304
Deer Park, WA 99006-1304
Phone (509) 292-2700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245206358 | Medicaid | WA |
Other providers in Deer Park, WA
- Danika Giard
- Brenda R Gilbert
- Chiayo Gilbert
- Byron Corrie Glenn
- Brandi Gore
- Craig Robert Gustafson
- Krystal Anne Guyette
- David Halonen
- Martha Joan Haney
- Brenda C. Hansen
All providers in Deer Park, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.