Individual provider Active NPI

Douglas Basso, DPM

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
National Provider Identifier
1295191112
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016.005775 Issued in IL
Practice address
2821 N Ballas Rd Ste C15
Saint Louis, MO 63131-2300
Phone
(618) 578-8667
Fax
(314) 983-9650
NPI assigned
Jan 7, 2016
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 135.000901 IL
Foot & Ankle Surgery Podiatrist 213ES0103X 2018037270 MO
Foot & Ankle Surgery Podiatrist 213ES0103X 016.005775 IL Primary

Addresses

Primary practice location

2821 N Ballas Rd Ste C15
Saint Louis, MO 63131-2300

Mailing address

4105 Endicott CT
Swansea, IL 62226-8210
Phone (618) 578-8667

Other practice location 1

4105 Endicott Ct
Swansea, IL 62226-8210
Phone (618) 578-8667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181012000327 IL Practitioner - Podiatry 4981956349 Reassigns benefits to 4 organizations
I20190111000067 MO Practitioner - Podiatry 4981956349 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Arizona Podiatric Med Program at Midwestern Un, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Touchette Regional Hospital IncGroup PAC ID 7416843370, 46 clinicians

Practice addresses (Care Compare)

2071 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 857-2700

5900 Bond Ave
Cahokia Heights, IL 62207-2326
Phone (618) 332-3060

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue44
Removal or shaving of skin growth29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016.005775ILMDFoot & Ankle Surgery Podiatrist
135.000901ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Basso Family LLC CurrentSince Apr 23, 2022 Accepting new patients
Best Foot Forward Corp CurrentSince Dec 3, 2022 Accepting new patients
Fairview Medical Group LLC CurrentSince Jul 25, 2023 Accepting new patients
Best Foot Forward Corp Foot & Ankle Surgery CurrentSince Dec 3, 2022 Accepting new patients
Preferred Podiatry Group PC CurrentSince Sep 1, 2023 Accepting new patients
Touchette Regional Hospital Inc CurrentSince Oct 29, 2018 Accepting new patients

Locations

168 N Clinton St
Fl 3
Chicago, IL 60661
Phone (201) 856-0224

5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060

123 Rottingham Ct
Edwardsville, IL 62025
Phone (618) 655-1385

331 Salem Pl
Ste 100
Fairview Hts, IL 62208
Phone (618) 578-8667

27 Auerbach Pl
Glen Carbon, IL 62034
Phone (618) 277-3700

1201 N Alton St
Lebanon, IL 62254
Phone (618) 537-4401

2071 Goose Lake Rd
Sauget, IL 62206
Phone (314) 872-1473

1000 Patterson St
Anderson, MO 64831
Phone (417) 845-3351

10 Lake Dr
Bonne Terre, MO 63628
Phone (573) 358-2800

1479 US Highway 61
Ste B
Crystal Cty, MO 63028
Phone (636) 224-8297

1550 Villa Dr
De Soto, MO 63020
Phone (636) 586-6559

2821 N Ballas Rd
Ste C15
Saint Louis, MO 63131
Phone (314) 983-0088

8790 Watson Rd
Ste 103
Saint Louis, MO 63119
Phone (314) 252-0708

Interoperability endpoints

  • Direct secure messaging: dbasso123@nsfaaci-il.direct.office.nextgen.com
  • Direct secure messaging: douglas.basso.1@9559.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12893/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1295191112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 ENDICOTT CT",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268210",
            "telephone_number": "618-578-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 N BALLAS RD STE C15",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312300",
            "telephone_number": "618-578-8667",
            "fax_number": "314-983-9650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4105 Endicott Ct",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622268210",
            "country_code": "US",
            "telephone_number": "618-578-8667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASSO",
        "first_name": "DOUGLAS",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-07",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135.000901",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2018037270",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.