Bassam K Bejjani, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A33388 Issued in CA

Practice address

14860 Roscoe Blvd
Suite 308 Bassam K Bejjani MD
Pamorama City, CA 91402-4698

Phone

(818) 780-3995

Fax

(818) 780-4061

NPI assigned

Aug 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CA

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

State licenses

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.

• Bassam K. Bejjani.,M.D. Inc

  • Urology Physician
  • Panorama City, CA
  • NPI 1508172404
  Authorized official Same address or phone

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487664207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14860 ROSCOE BLVD",
            "address_2": "SUITE 308 BASSAM K BEJJANI MD",
            "city": "PAMORAMA CITY",
            "state": "CA",
            "postal_code": "914024698",
            "telephone_number": "818-780-3995",
            "fax_number": "818-780-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14860 ROSCOE BLVD",
            "address_2": "SUITE 308 BASSAM K BEJJANI MD",
            "city": "PAMORAMA CITY",
            "state": "CA",
            "postal_code": "914024698",
            "telephone_number": "818-780-3995",
            "fax_number": "818-780-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEJJANI",
        "first_name": "BASSAM",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A33388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A333880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.