Individual provider Active NPI

Barbara M Bazemore

  • Registered Nurse
  • Brentwood, NY
National Provider Identifier
1285264762
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
719716 Issued in NY
Practice address
998 Crooked Hill Rd
Brentwood, NY 11717-1019
Phone
(631) 796-9152
NPI assigned
Jan 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 719716 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
Brentwood, NY 11717-1019

Mailing address

1511 E Forks Rd
Bay Shore, NY 11706-3108

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

State licenses

LicenseStateTypeSpecialty
719716NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1285264762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 E FORKS RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-796-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZEMORE",
        "first_name": "BARBARA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "719716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.