Individual provider Active NPI

Leonid Basovich, DO, DAOBFP

  • Family Medicine Physician
  • Citrus Heights, CA
National Provider Identifier
1285626515
Registry record updated Jun 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A13731 Issued in CA
Practice address
7777 Greenback LN Ste 103
Citrus Heights, CA 95610-5800
Phone
(916) 905-1777
Fax
(888) 855-7555
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X A13731 CA
Geriatric Medicine (Family Medicine) Physician 207QG0300X A13731 CA
Family Medicine Physician 207Q00000X A13731 CA Primary

Addresses

Primary practice location

7777 Greenback LN Ste 103
Citrus Heights, CA 95610-5800

Mailing address

7777 Greenback LN Ste 103
Citrus Heights, CA 95610-5800
Phone (916) 905-1777

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
I20150618001297 CA Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 4981633401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
New York University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7777 Greenback LN
Suite 103
Citrus Heights, CA 95610-5800
Phone (916) 905-1777

Hospital & facility affiliations

  • Your Choice Home Health, Inc Home health agency, Rancho Cordova, CA, CCN 053168
  • Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A13731CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leonid Basovich DO Inc CurrentSince Apr 22, 2019 Accepting new patients
Primary Care Family Doctor P.C. Neuromusculoskeletal Medicine & Omm Current Accepting new patients
Quantum Healthcare Medical Associates Inc. Family Medicine Past Accepting new patients

Locations

7777 Greenback Ln
Ste 103
Citrus Hts, CA 95610
Phone (916) 835-7777

3260 Beard Rd
Ste 5
Napa, CA 94558
Phone (707) 256-5000

565 Route 25A
Ste 101
Miller Place, NY 11764
Phone (631) 731-1836

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592006400000",
    "number": "1285626515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 GREENBACK LN STE 103",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956105800",
            "telephone_number": "916-905-1777",
            "fax_number": "888-855-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 GREENBACK LN STE 103",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956105800",
            "telephone_number": "916-905-1777",
            "fax_number": "888-855-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASOVICH",
        "first_name": "LEONID",
        "name_prefix": "Dr.",
        "credential": "DO, DAOBFP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "A13731",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A13731",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A13731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

Verify at the official NPI Registry.