Individual provider Active NPI

Basil Felahy, MD

  • Family Medicine Physician
  • Lynwood, CA
National Provider Identifier
1245389238
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A36908 Issued in CA
Practice address
11050 Atlantic Ave
Lynwood, CA 90262-3068
Phone
(310) 635-3800
Fax
(310) 635-0364
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A36908 CA Primary

Addresses

Primary practice location

11050 Atlantic Ave
Lynwood, CA 90262-3068

Mailing address

11050 Atlantic Ave
Lynwood, CA 90262-3068
Phone (310) 635-3800

Other identifiers 2

IdentifierTypeStateIssuer
A36908OtherCAMEDICAL LICENSE
00A369080MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080404000355 CA Practitioner - Family PracticePractitioner - General Surgery 4587741251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11050 Atlantic Ave
Lynwood, CA 90262-3068
Phone (310) 635-3800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36908CAMDChiropractor
A36908CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Los Angeles Hospital, Inc Past Accepting new patients
Gardena Hospital LP Past Accepting new patients
Med-Pro Family Clinic, a Medical Corporation Surgery Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1245389238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623068",
            "telephone_number": "310-635-3800",
            "fax_number": "310-635-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623068",
            "telephone_number": "310-635-3800",
            "fax_number": "310-635-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELAHY",
        "first_name": "BASIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A36908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A36908",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A369080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

Verify at the official NPI Registry.