Bassem Timothy Kodsi, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TRN17241 Issued in FL

Practice address

1707 N Main St
Gainesville, FL 32609-3650

Phone

(352) 265-9592

NPI assigned

Jul 5, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1639434715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF COMMUNITY HEALTH AND FAMILY",
            "address_2": "1600 SW ARCHER RD, SUITE N107",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 N MAIN ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093650",
            "telephone_number": "352-265-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODSI",
        "first_name": "BASSEM TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN17241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid V Kobler, MS, RD, LDN
• Andrea Kocher
• April Rose Kocher, RN
• Swapna Kochuveettil, ARNP
• Kodp PLLC
• Christopher John Koenig, ATC
• Kyle Andrew Koenig, PHARMD
• Megan Koenig, MD
• Sandra Leigh Koenig, OTR/L
• Samuel James Koenigsberg

• Family Medicine Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.