Active NPI
Katherina Kobraei Basic, MD
- Dermatology Physician
- Gainesville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- ME105569
- Practice address
- 1601 SW Archer Rd
Gainesville, FL 32608-1197 - Phone
- (352) 337-4900
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | ME105569 | FL | Primary |
Addresses
Primary practice location
1601 SW Archer Rd
Gainesville, FL 32608-1197
Mailing address
1601 SW Archer Rd
Gainesville, FL 32608-1135
Phone (352) 337-4900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002471100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Wright State University Boonshoft School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
410 N Main St
Suite 9
Chiefland, FL 32626-0866
Phone (352) 260-0170
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 53 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 31 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME105569 | FL | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology of Gainesville LLC | Dermatology | Current | Accepting new patients |
| Dartmouth-Hitchcock Clinic | Internal Medicine | Current | Accepting new patients |
| U-U Pediatric Dermatology | Past | Accepting new patients |
Locations
410 N Main St
Ste 9
Chiefland, FL 32626
Phone (352) 260-0170
13575 NW 1st Ln
Ste 10
Newberry, FL 32669
Phone (352) 260-0170
315 NW 138th Ter
Newberry, FL 32669
Phone (352) 443-0353
590 Court St
Keene, NH 03431
Phone (603) 354-5454
1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922
Organizations & group practices 3
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.
-
- Dermatology Physician
- Newberry, FL
- NPI 1437633880
-
- Internal Medicine Physician
- Lebanon, NH
- NPI 1548210198
-
- Pediatric Dermatology Physician
- Salt Lake City, UT
- NPI 1235339193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687478400000",
"number": "1457448342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326081135",
"telephone_number": "352-337-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326081197",
"telephone_number": "352-337-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASIC",
"first_name": "KATHERINA",
"middle_name": "KOBRAEI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2023-06-23",
"certification_date": "2023-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "ME105569",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002471100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.
- 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.