Organization Active NPI

Bassi Clinic PLLC

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1376141598
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BASSI CLINIC PLLC
Practice address
11110 N Tatum Blvd Ste 103
Phoenix, AZ 85028-1607
Phone
(602) 354-3311
NPI assigned
Oct 9, 2020
Last updated
Oct 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Authorized official

Name
Tarun BassiNPI 1538277587
Title
Owner/Authorized Official
Phone
(646) 352-2619

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

11110 N Tatum Blvd Ste 103
Phoenix, AZ 85028-1607

Mailing address

11110 N Tatum Blvd Ste 103
Phoenix, AZ 85028-1607

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL tarun@bassiclinic.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210219001023 AZ Part B Supplier - Clinic/Group Practice 3274948500 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2230312Bassi Clinic11110 N Tatum Blvd Ste 103, Phoenix, AZ 85028Certificate of waiverJul 20, 2027

National Provider Directory

National Provider Directory

Locations

14175 W Indian School Rd
Ste B4139
Goodyear, AZ 85395

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1376141598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 N TATUM BLVD STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 N TATUM BLVD STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850281607",
            "telephone_number": "602-354-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASSI CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "BASSI",
        "authorized_official_first_name": "TARUN",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "646-352-2619"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tarun@bassiclinic.com",
            "affiliation": "N",
            "address_1": "11110 N Tatum Blvd Ste 103",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850281607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.