Individual provider Active NPI

Bassem Philip, MD

  • Internal Medicine Physician
  • Lakewood Ranch, FL
National Provider Identifier
1598061129
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME110747 Issued in FL
Practice address
14405 Arbor Green TRL
Lakewood Ranch, FL 34202-8409
Phone
(941) 917-7080
Fax
(941) 917-7085
NPI assigned
Jan 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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 ME110747 FL Primary

Addresses

Primary practice location

14405 Arbor Green TRL
Lakewood Ranch, FL 34202-8409

Mailing address

PO Box 947407
Atlanta, GA 30394-7407
Phone (941) 917-2600

Other identifiers 2

IdentifierTypeStateIssuer
004363700MedicaidFL
14H47OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111108000452 FL Practitioner - Internal Medicine 0840463824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMH Physician Services IncGroup PAC ID 1355240177, 781 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

14405 Arbor Green TRL
Lakewood Ranch, FL 34202-8409
Phone (941) 917-7080

17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Internal Medicine CurrentSince Dec 13, 2021 Accepting new patients
SMH Physician Services Inc PastSince Oct 31, 2021 Accepting new patients
Memorial Family Practice Associates, LLC Past Accepting new patients

Locations

14405 Arbor Green Trl
Lakewood Ranch, FL 34202
Phone (941) 917-7080

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

Interoperability endpoints

  • Direct secure messaging: bassem.philip@fpg.directbygreenway.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1296259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1598061129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14405 ARBOR GREEN TRL",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342028409",
            "telephone_number": "941-917-7080",
            "fax_number": "941-917-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "BASSEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-29",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME110747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004363700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14H47",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.