NPIMap

Individual provider Active NPI

Shyamal Raj Bastola, MD

  • Hematology & Oncology Physician
  • Zanesville, OH
National Provider Identifier
1306003033
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
35.097144 Issued in OH
Practice address
2951 Maple Ave
Zanesville, OH 43701-1406
Phone
(740) 454-5271
Fax
(740) 455-7588
NPI assigned
May 20, 2008
Last updated
May 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X 35.097144 OH Primary

Addresses

Primary practice location

2951 Maple Ave
Zanesville, OH 43701-1406

Mailing address

945 Bethesda Dr
Suite 200
Zanesville, OH 43701-0801
Phone (740) 454-4788

Other practice location 1

1246 Ashland Ave
Suite 205
Zanesville, OH 43701-2861
Phone (740) 454-5271

Other identifiers 1

IdentifierTypeStateIssuer
3153537MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110720000560 OH Practitioner - Hematology/OncologyPractitioner - Internal Medicine 7911182696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

2951 Maple Ave
Zanesville, OH 43701-1406
Phone (740) 454-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.097144OHMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Medical Group, LLC CurrentSince Jul 15, 2011 Accepting new patients
Genesis Medical Group LLC Multi-Specialty CurrentSince Jul 15, 2011 Accepting new patients

Locations

1246 Ashland Ave
Ste 204
Zanesville, OH 43701
Phone (740) 450-6167

1246 Ashland Ave
Ste 205
Zanesville, OH 43701
Phone (740) 454-5000

945 Bethesda Dr
Ste 330
Zanesville, OH 43701
Phone (740) 454-4038

2951 Maple Ave
Zanesville, OH 43701
Phone (740) 454-4000

945 Bethesda Dr
Ste 200
Zanesville, OH 43701
Phone (740) 454-4788

Organizations & group practices 2

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 8

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1306003033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 BETHESDA DR",
            "address_2": "SUITE 200",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437010801",
            "telephone_number": "740-454-4788",
            "fax_number": "740-450-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011406",
            "telephone_number": "740-454-5271",
            "fax_number": "740-455-7588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1246 Ashland Ave",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Zanesville",
            "state": "OH",
            "postal_code": "437012861",
            "country_code": "US",
            "telephone_number": "740-454-5271",
            "fax_number": "740-455-7588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASTOLA",
        "first_name": "SHYAMAL",
        "middle_name": "RAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35.097144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3153537",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.