Marvin J Base, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

187770 Issued in NY

Practice address

9308 Queens Blvd # 1B1C
Rego Park, NY 11374-1135

Phone

(718) 806-1434

Fax

(718) 806-1435

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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 and National Provider Directory roles.

• North Shore Medical PLLC

  • Internal Medicine Physician
  • Rego Park, NY
  • NPI 1083966170
  NPD Authorized official
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  NPD (past)
• Saul Maslavi MD PC

  • Family Medicine Physician
  • Bayside, NY
  • NPI 1275611527
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1366401853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9308 QUEENS BLVD # 1B1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741135",
            "telephone_number": "718-806-1434",
            "fax_number": "718-806-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9308 QUEENS BLVD # 1B1C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741135",
            "telephone_number": "718-806-1434",
            "fax_number": "718-806-1435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASE",
        "first_name": "MARVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "187770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01888251",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julissa Jeanette Barreto Sierra, CASAC
• Ella Bartov, PT
• Barukh Medical Transportation Inc.
• Deysi Veronica Barzallo, LCSW
• Nadine Lucia Bascombe, DPT
• Shazia I Basir Quddusi
• Elizabeth Bassano, LCSW-R
• Carlos M Bastidas, RN-BSN
• Maia V Batash, MD
• Steven Batash, M.D.

• Internal Medicine Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.