Individual provider Active NPI

Mark R Bassett, MD

  • Otolaryngology Physician
  • Spokane, WA
National Provider Identifier
1619969045
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00020088 Issued in WA
Practice address
400 E 5TH Ave
Spokane, WA 99202-1334
Phone
(509) 838-2531
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD00020088 WA Primary

Addresses

Primary practice location

400 E 5TH Ave
Spokane, WA 99202-1334

Mailing address

PO Box 3649
Spokane, WA 99220-3649

Other identifiers 1

IdentifierTypeStateIssuer
1037514MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040708000672 WA Practitioner - Otolaryngology 8527046440 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00020088WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Mar 1, 2018 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

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.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1619969045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3649",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 5TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021334",
            "telephone_number": "509-838-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00020088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1037514",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.