Jean Claude Bassila, M.D.
Individual provider Active NPI Nephrology Physician · Santa Rosa, CA
NPI 1487817854 · NPPES record last updated Apr 20, 2022
Key facts
- NPI
- 1487817854
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- A145695 (CA)
- Practice address
- 4720 Hoen Ave Ste 1
Santa Rosa, CA 95405-7867 - Phone
- (707) 527-9510
- Fax
- (833) 941-2589
- NPI assigned
- Jul 7, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 21
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- East Bay Nephrology Medical Group Inc
Barton Medical Foundation
Telemedicine Group PC
Siskiyou Hospital Inc
Practice addresses (Care Compare)
127 Hospital Dr
Suite 102
Vallejo, CA 94589-2500
Phone (707) 642-7510
2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5807
3400 Douglas Blvd
Suite 170
Roseville, CA 95661-4281
Phone (916) 740-3721
444 Bruce St
Yreka, CA 96097-3450
Phone (530) 842-4121
4720 Hoen Ave
Suite 1
Santa Rosa, CA 95405-7867
Phone (707) 527-9510
Hospital & facility affiliations
- Bma Santa Rosa
- Fresenius Kidney Care of Petaluma
- Providence Santa Rosa Memorial Hospital
- Sutter Santa Rosa Regional Hospital
- Novato Community Hospital
- Mayers Memorial Hospital
- Adventist Health Ukiah Valley
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.9 of 100
- Quality
- 81.89
- Promoting interoperability
- 99
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.03 of 100
- Quality
- 78.37
- Improvement activities
- 40
- Cost
- 47.2
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.71 of 100
- Quality
- 89.85
- Promoting interoperability
- 94.05
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180627000513 | CA | Practitioner - Nephrology |
6204065220 | Reassigns benefits to 6 organizations |
| I20260528003886 | IN | Practitioner - Nephrology | 6204065220 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A145695 | CA | MD | Nephrology Physician |
| A145965 | CA | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Karuk Tribe | Current |
Accepting new patients | |
| Morgan County Georgia Hospital Authority | Current | Accepting new patients | |
| Telehealth Specialty Medical Group | Current |
Accepting new patients | |
| Karuk Tribe | Current |
Accepting new patients | |
| Tahoe Carson Valley Medical Group Inc | Internal Medicine | Current |
Accepting new patients |
| Karuk Tribe | Current | Accepting new patients | |
| East Bay Nephrology Medical Group, Inc. | Nephrology | Current |
Accepting new patients |
| Barton Medical Foundation | Current |
Accepting new patients | |
| East Bay Nephrology Medical Group, Inc. | Nephrology | Current |
Accepting new patients |
| Kidney Solutions Inc | Nephrology | Current |
Accepting new patients |
| SRM Alliance Hospital Services | Past | Accepting new patients | |
| Tele-Medicine Services Ny, PLLC | Internal Medicine | Past |
Accepting new patients |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Sutter Bay Hospitals | Past | Accepting new patients | |
| PHC-Cleveland Inc. | Past | Accepting new patients | |
| California Pacific Medical Group, Inc. | Past | Accepting new patients | |
| Sutter Bay Hospitals | Past | Accepting new patients | |
| Nagarathna G. Manjappa M.D. Inc. | Nephrology | Past |
Accepting new patients |
Locations
3230 Beard Rd
Ste 1
Napa, CA 94558
Phone (707) 253-7005
3400 Douglas Blvd
Ste 170
Roseville, CA 95661
Phone (855) 446-8628
3400 Douglas Blvd
Ste 225
Roseville, CA 95661
Phone (916) 740-3721
1005 Northgate Dr
San Rafael, CA 94903
Phone (415) 996-4793
4720 Hoen Ave
Ste 1
Santa Rosa, CA 95405
Phone (707) 527-9510
1020 2nd St
Santa Rosa, CA 95404
Phone (707) 527-5350
2209 South Ave
Ste Ab
South Lake Tahoe, CA 96150
Phone (530) 600-1960
1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660
2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420
2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554
125 Hospital Dr
Vallejo, CA 94589
Phone (707) 642-7510
127 Hospital Dr
Ste 102
Vallejo, CA 94589
Phone (707) 643-9010
1519 S Oregon St
Yreka, CA 96097
Phone (530) 842-9200
Interoperability endpoints
- jeanbassila@mmc.medalliesdirect.net
- jbassila411121@hisp.ehr.sutterhealth.org
- telemed2u.jeanclaudebassila@160918.advancedmd-direct.com
- jean-claude.bassila.1@23281.direct.athenahealth.com
- https://api.platform.athenahealth.com/23281/brand/1/csg/1/fhir/r4
- https://api.platform.athenahealth.com/12105/brand/1/csg/1/fhir/r4
- bassila_jean_claude_md@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 22784 | MS | |
| Nephrology Physician | 207RN0300X | A145965 | CA | |
| Nephrology Physician | 207RN0300X | 22784 | MS | |
| Nephrology Physician | 207RN0300X | A145695 | CA | Yes |
Addresses
Primary practice location
4720 Hoen Ave Ste 1
Santa Rosa, CA 95405-7867
Mailing address
1005 Northgate Dr # 121
San Rafael, CA 94903-2500
Phone (707) 527-9510
Other practice location 1
3230 Beard Rd Ste 1
Napa, CA 94558-3659
Phone (707) 253-7005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09481295 | Medicaid | MS |
Other providers in Santa Rosa, CA
- Brikell Bascherini-Burns
- Sarah Anne Basham
- Farid Bashti
- Jazon A Basped
- Sharon Diane Bass
- Barry Warren Bastian
- Kelly A. Bastoni
- Tatjana Monique Basurto
- Daniel Batt
- Richard Baudrand
All providers in Santa Rosa, CA · Nephrology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.