NPIMap

Individual provider Active NPI

Shaik Iqbal Basha, MD

  • Hospitalist Physician
  • Medford, OR
National Provider Identifier
1578712378
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD154567 Issued in OR
Practice address
1111 Crater Lake Ave
Medford, OR 97504-6241
Phone
(541) 732-5545
Fax
(541) 732-5548
NPI assigned
Sep 17, 2008
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD154567 OR
Hospitalist Physician 208M00000X MD154567 OR Primary

Addresses

Primary practice location

1111 Crater Lake Ave
Medford, OR 97504-6241

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
500640088MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbasha140013@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20111027000862 OR Practitioner - HospitalistPractitioner - Family Practice 0244403723 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oregon Hospitalists PCGroup PAC ID 1456308493, 51 clinicians
Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (541) 732-5545

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 282-6770

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

9205 SW Barnes Rd
Portland, OR 97225-6603

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 29, 2017 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Jan 17, 2015 Accepting new patients
Southern Oregon Hospitalists PC Hospitalist CurrentSince Jun 1, 2025 Accepting new patients
Providence Health & Services Oregon Family Medicine Current Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 1, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 17, 2015 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2011 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 29, 2017 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Jan 29, 2017 Accepting new patients
Asante Physician Partners Family Medicine CurrentSince Jul 30, 2022 Accepting new patients
Providence Health & Services Oregon CurrentSince Mar 1, 2020 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2011 Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

625 SW Ramsey Ave
Ste A
Grants Pass, OR 97527
Phone (541) 474-5004

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

2640 E Barnett Rd
#E333
Medford, OR 97504

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Interoperability endpoints

  • Direct secure messaging: sbasha140013@oc.providencedirect.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1578712378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046241",
            "telephone_number": "541-732-5545",
            "fax_number": "541-732-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHA",
        "first_name": "SHAIK",
        "middle_name": "IQBAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-17",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD154567",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD154567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500640088",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbasha140013@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1111 Crater Lake Ave",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975046241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.