Individual provider Active NPI

Brandon Michael Basehore, DO

  • Dermatology Physician
  • Clearwater, FL
National Provider Identifier
1598111999
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
OS20484 Issued in FL
Practice address
3165 N McMullen Booth Rd Ste C2
Clearwater, FL 33761-2020
Phone
(813) 321-1786
Fax
(813) 321-1787
NPI assigned
May 4, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X DR.0063699 CO
MOHS-Micrographic Surgery Physician 207ND0101X OS20484 FL
MOHS-Micrographic Surgery Physician 207ND0101X DR.0063699 CO
Dermatology Physician 207N00000X OS20484 FL Primary

Addresses

Primary practice location

3165 N McMullen Booth Rd Ste C2
Clearwater, FL 33761-2020

Mailing address

18228 N US Highway 41
Lutz, FL 33549-4400
Phone (813) 321-1786

Other practice location 1

8580 Scarborough Dr
Colorado Springs, CO 80920-7583
Phone (719) 531-5400

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
I20231114003474 FL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 2062708712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
West Virginia School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Skin SolutionsGroup PAC ID 7416018221, 102 clinicians

Practice addresses (Care Compare)

2467 Enterprise Rd
Suite a
Clearwater, FL 33763-1724
Phone (813) 321-1786

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.08 of 100Reported as group
Quality
81.46
Improvement activities
40
Cost
71.65

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision133
Removal of skin lesions3277
Removal of skin cancer229
Removal of nail tissue1-10
Removal or shaving of skin growth33
Skin biopsy925

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS20484FLMDAnesthesiology Physician
DR.0063699COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Skin Solutions Dermatology CurrentSince Jan 1, 2024 Accepting new patients
Douglas K Pierce MD PA Past Accepting new patients

Locations

2467 Enterprise Rd
Ste A
Clearwater, FL 33763
Phone (727) 350-2949

3165 N McMullen Booth Rd
Ste C2
Clearwater, FL 33761
Phone (727) 799-5273

4651 Van Dyke Rd
Lutz, FL 33558

18228 N US Highway 41
Lutz, FL 33549

11200 Seminole Blvd
Ste 205
Seminole, FL 33778
Phone (727) 820-1786

8787 Bryan Dairy Rd
Ste 360
Seminole, FL 33777
Phone (727) 393-4900

5200 Seminole Blvd
St Petersburg, FL 33708
Phone (727) 392-3376

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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 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": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1598111999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18228 N US HIGHWAY 41",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494400",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3165 N MCMULLEN BOOTH RD STE C2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612020",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8580 Scarborough Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809207583",
            "country_code": "US",
            "telephone_number": "719-531-5400",
            "fax_number": "719-531-9545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASEHORE",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0063699",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "OS20484",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CO",
            "license": "DR.0063699",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS20484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.