Individual provider Active NPI

Makala Marie Bascome, DO

  • Internal Medicine Physician
  • Agana Heights, GU
National Provider Identifier
1508487760
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102206849 Issued in VA
Practice address
US Naval Hospital Guam
Farenholt Ave, BLDG 50
Agana Heights, GU 96910
Phone
(671) 344-9340
NPI assigned
Apr 29, 2020
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102206849 VA Primary

Addresses

Primary practice location

US Naval Hospital Guam
Farenholt Ave, BLDG 50
Agana Heights, GU 96910

Mailing address

PSC 455 Box 208
Fpo, AP 96540-0003

Other practice location 1

34800 Bob Wilson Dr
San Diego, CA 92134-1098
Phone (601) 679-3968

Other practice location 2

8901 Wisconsin Ave
Bethesda, MD 20889-0004
Phone (301) 319-8278

Other practice location 3

1801 Fuller Rd # 367
Meridian, MS 39309-0004
Phone (601) 679-3968

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20241211004813 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3870029903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102206849VAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1508487760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 455 BOX 208",
            "city": "FPO",
            "state": "AP",
            "postal_code": "965400003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US NAVAL HOSPITAL GUAM",
            "address_2": "FARENHOLT AVE, BLDG 50",
            "city": "AGANA HEIGHTS",
            "state": "GU",
            "postal_code": "96910",
            "telephone_number": "671-344-9340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "601-679-3968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890004",
            "country_code": "US",
            "telephone_number": "301-319-8278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 Fuller Rd # 367",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393090004",
            "country_code": "US",
            "telephone_number": "601-679-3968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASCOME",
        "first_name": "MAKALA",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102206849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agana Heights, GU

Sources for this page

Verify at the official NPI Registry.