Mervat Basta, M.D.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

26169 Issued in AZ

Practice address

4825 S Highway 95 # 2-356
Fort Mohave, AZ 86426

Phone

(888) 206-5902

Fax

(480) 466-7536

NPI assigned

Jan 29, 2007

Last updated

Dec 4, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 enrollments

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 2

Specialty

Anesthesiology

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Anesthesia PLLCGroup PAC ID 4284813940, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeastern Anesthesia PLLC

  • Anesthesiology Physician
  • Sierra Vista, AZ
  • NPI 1487956504
  Medicare reassignment Care Compare group NPD
• Regents of the University of

  dba University Anesthesia Associates

  • Anesthesiology Physician
  • Orange, CA
  • NPI 1487602546
  Medicare reassignment NPD
• Valley Regional Anesthesia Associates Inc

  • Anesthesiology Physician
  • Fresno, CA
  • NPI 1578272415

  AZ

  Medicare reassignment NPD
• Sun Health MRI Center

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Sun City West, AZ
  • NPI 1427001379
  NPD (past)
• Bullhead City Clinic Corp

  dba Laughlin Walk In Care

  • Family Medicine Physician
  • Laughlin, NV
  • NPI 1700240884
  NPD (past)
• Ctca Physicans Group of Oklahoma, Inc

  • Specialist
  • Tulsa, OK
  • NPI 1053309591
  NPD (past)

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

• Havasu Regional Medical Center LLC

  dba Havasu Regional Medical Center

  • Rural Acute Care Hospital
  • Lake Havasu City, AZ
  • NPI 1780761866
  Care Compare affiliation
• Kingman Healthcare, Inc

  dba Kingman Regional Medical Center

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1285770115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52650",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852080133",
            "telephone_number": "888-206-5902",
            "fax_number": "480-466-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 S HIGHWAY 95 # 2-356",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "86426",
            "telephone_number": "888-206-5902",
            "fax_number": "480-466-7536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2081 E Santa Fe Dr",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864428703",
            "country_code": "US",
            "telephone_number": "928-758-6109",
            "fax_number": "928-704-7235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5330 S Highway 95",
            "address_purpose": "LOCATION",
            "city": "Fort Mohave",
            "state": "AZ",
            "postal_code": "864269225",
            "country_code": "US",
            "telephone_number": "888-206-5902",
            "fax_number": "480-466-7536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2081 E Santa Fe Dr",
            "address_purpose": "LOCATION",
            "city": "Bullhead City",
            "state": "AZ",
            "postal_code": "864428703",
            "country_code": "US",
            "telephone_number": "928-758-6109",
            "fax_number": "928-704-7235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASTA",
        "first_name": "MERVAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AZ",
            "license": "26169",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "26169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick L Ballou, PA-C
• Rose Marie Bard-Jensen, NP
• Kayla Barnett, PA-C
• Alan Joseph Barton, MD
• Hylie Elaine Barton, BCBA
• Thomas Baughman, L.I.S.A.C.
• Richard P Benedict, MD
• Nathan Eric Beneze, M.D.
• Donna Bennett
• Dayna Blake, FNP- BC

• General Acute Care Hospital in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• General Acute Care Hospital in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.