Trina Binta Bascom

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

402773 Issued in NY

Practice address

11207 Rockaway Blvd
South Ozone Park, NY 11420-1031

Phone

(917) 361-4502

NPI assigned

Dec 11, 2018

Last updated

Jun 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: tbascom63841@nychhc.direct-ci.com

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1659842078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11207 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114201031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11207 ROCKAWAY BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114201031",
            "telephone_number": "917-361-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCOM",
        "first_name": "TRINA",
        "middle_name": "BINTA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "610850",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Balance Art Acupuncture P.C.
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• Kailass Bansi
• Esther Barak, LMSW
• Margaret Barry
• Kamlawattie Basdeo
• Timothy Francis Beck, PHARMD
• Lalta Persaud - Jaikaran Bedessie
• Dyann Devi Beer
• Cynshae C Beeson

• Psychiatric/Mental Health Nurse Practitioner in South Ozone Park, NY
• Providers in South Ozone Park, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.