Individual provider Active NPI

John Robert Basile, DDS, DMSC.

  • Oral and Maxillofacial Pathology Dentistry
  • Baltimore, MD
National Provider Identifier
1508190182
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
11284 Issued in MD
Practice address
650 W Baltimore St
7-North
Baltimore, MD 21201-1510
Phone
(410) 706-7936
Fax
(410) 706-0519
NPI assigned
Sep 29, 2009
Last updated
Sep 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 11284 MD Primary

Addresses

Primary practice location

650 W Baltimore St
7-North
Baltimore, MD 21201-1510

Mailing address

650 W Baltimore St
7-North
Baltimore, MD 21201-1510
Phone (410) 706-7936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331001689 MD Practitioner - Oral and Maxillofacial Pathology 1254854201 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
U M FDSP Associates PA Current Accepting new patients
U M FDSP Associates PA Oral and Maxillofacial Pathology CurrentSince Jan 26, 2025 Accepting new patients
Oral Medicine Consultants Oral and Maxillofacial Pathology CurrentSince Jan 26, 2025 Accepting new patients

Locations

650 W Baltimore St
#7
Baltimore, MD 21201
Phone (410) 706-7625

650 W Baltimore St
Rm 5201
Baltimore, MD 21201
Phone (410) 706-7063

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1508190182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST",
            "address_2": "7-NORTH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-7936",
            "fax_number": "410-706-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W BALTIMORE ST",
            "address_2": "7-NORTH",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011510",
            "telephone_number": "410-706-7936",
            "fax_number": "410-706-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASILE",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS, DMSC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MD",
            "license": "11284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.