Individual provider Active NPI

Surmin Singh Basra, MD

  • Internal Medicine Physician
  • Roanoke, VA
National Provider Identifier
1326560046
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
61282861 Issued in WA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7000
NPI assigned
Jul 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 61282861 WA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

3322 Circle Brook Dr Apt J
Roanoke, VA 24018-8252
Phone (267) 939-1406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20221026002944 WA Practitioner - Internal Medicine 4789957788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61282861WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Washington, PC Internal Medicine CurrentSince Aug 12, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Aug 12, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Aug 12, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

Interoperability endpoints

  • Direct secure messaging: sbasra92936@direct.carilionclinic.org

Organizations & group practices 5

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 1

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1326560046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 CIRCLE BROOK DR APT J",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240188252",
            "telephone_number": "267-939-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASRA",
        "first_name": "SURMIN",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-14",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "61282861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.