Individual provider Active NPI

Thomas W. Bassham, PA-C

  • Surgical Physician Assistant
  • Tulsa, OK
National Provider Identifier
1588647002
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1371 Issued in OK
Practice address
2488 E 81St St Ste 290
Tulsa, OK 74137-4265
Phone
(918) 494-2665
Fax
(918) 927-3201
NPI assigned
Nov 29, 2005
Last updated
May 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1371 OK
Surgical Physician Assistant 363AS0400X 1371 OK Primary

Addresses

Primary practice location

2488 E 81St St Ste 290
Tulsa, OK 74137-4265

Mailing address

2488 E 81St St Ste 290
Tulsa, OK 74137-4265
Phone (918) 494-2665

Other identifiers 1

IdentifierTypeStateIssuer
100180730AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041110000822 OK Practitioner - Physician Assistant 6709774573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics of Oklahoma PLLCGroup PAC ID 8426320912, 90 clinicians

Practice addresses (Care Compare)

205 E B St
Jenks, OK 74037-3906
Phone (918) 299-7937

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1371OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedics of Oklahoma PLLC CurrentSince Jan 1, 2017 Accepting new patients
Group Practice Associates, Inc. Past Accepting new patients
Freeman-Oak Hill Health System PastSince Jan 1, 1990 Accepting new patients

Locations

205 E B St
Jenks, OK 74037
Phone (918) 299-4411

2488 E 81st St
Ste 290
Tulsa, OK 74137
Phone (918) 494-2665

6585 S Yale Ave
Ste 200
Tulsa, OK 74136
Phone (918) 481-2767

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGJHAD

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1588647002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-494-2665",
            "fax_number": "918-927-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2488 E 81ST ST STE 290",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741374265",
            "telephone_number": "918-494-2665",
            "fax_number": "918-927-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSHAM",
        "first_name": "THOMAS",
        "middle_name": "W.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1371",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "1371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100180730A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.