NPIMap

Individual provider Active NPI

Mark Basha Keroles, MD

  • Clinical Neurophysiology Physician
  • Rancho Palos Verdes, CA
National Provider Identifier
1548898554
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
A187307 Issued in CA
Practice address
30051 Grandpoint LN
Rancho Palos Verdes, CA 90275-6425
Phone
(484) 351-8459
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X A187307 CA Primary
Clinical Neurophysiology Physician 2084N0600X 46213 OK

Addresses

Primary practice location

30051 Grandpoint LN
Rancho Palos Verdes, CA 90275-6425

Mailing address

2915 W Bitters Rd Ste 201
San Antonio, TX 78248-2007

Other practice location 1

13401 Railway Dr
Oklahoma City, OK 73114-2272
Phone (484) 351-8459

Other practice location 2

400 N Ashley Dr
Tampa, FL 33602-4300
Phone (484) 351-8459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630003814 CA Practitioner - Neurology 1254844541 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sensory Testing Systems LLCGroup PAC ID 2062686330, 8 clinicians
Bruin Neurophysiology PCGroup PAC ID 4486963279, 4 clinicians
Wildcat Neurophysiology, PCGroup PAC ID 4789943804, 22 clinicians
Yankee Neurophysiology PCGroup PAC ID 5698929883, 10 clinicians
American Intraoperative Monitoring LLCGroup PAC ID 8527230333, 16 clinicians

Practice addresses (Care Compare)

30051 Grandpoint LN
Rancho Palos Verdes, CA 90275-6425
Phone (484) 351-8459

Hospital & facility affiliations

  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573
  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270
  • Northridge Hospital Medical Center Hospital, Northridge, CA, CCN 050116
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Honorhealth Scottsdale Osborn Medical Center Hospital, Scottsdale, AZ, CCN 030038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A187307CAMDClinical Neurophysiology Physician
46213OKMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yankee Neurophysiology, P.C. Clinical Neurophysiology CurrentSince Jan 1, 2026 Accepting new patients
Bruin Neurophysiology, P.C. Clinical Neurophysiology CurrentSince Jun 1, 2025 Accepting new patients
Mpower Clinical TX Clinical Neurophysiology CurrentSince Nov 14, 2025 Accepting new patients
American Intraoperative Monitoring LLC Clinical Neurophysiology CurrentSince Sep 8, 2025 Accepting new patients
Wildcat Neurophysiology, PC Clinical Neurophysiology CurrentSince Jul 14, 2025 Accepting new patients
Sensory Testing Systems, LLC Clinical Neurophysiology CurrentSince Jul 1, 2025 Accepting new patients

Locations

19582 Beach Blvd
Ste 270
Huntington Beach, CA 92648
Phone (714) 232-8833

520 Superior Ave
Ste 205
Newport Beach, CA 92663
Phone (949) 650-2462

13401 Railway Dr
Oklahoma City, OK 73114
Phone (405) 841-7826

1141 N Loop 1604 E
Ste 105484
San Antonio, TX 78232

2915 W Bitters Rd
Ste 201
San Antonio, TX 78248

Organizations & group practices 6

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1548898554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 W BITTERS RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782482007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30051 GRANDPOINT LN",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902756425",
            "telephone_number": "484-351-8459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13401 Railway Dr",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731142272",
            "country_code": "US",
            "telephone_number": "484-351-8459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Ashley Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336024300",
            "country_code": "US",
            "telephone_number": "484-351-8459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEROLES",
        "first_name": "MARK",
        "middle_name": "BASHA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "A187307",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OK",
            "license": "46213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

Verify at the official NPI Registry.