Carmen Millicent Bassaragh, ANP-C

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

F305792- Issued in NY

Practice address

421 Deer Park Ave
Babylon, NY 11702-2313

Phone

(631) 941-1000

NPI assigned

May 22, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1679833784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022313",
            "telephone_number": "631-941-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117022313",
            "telephone_number": "631-941-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSARAGH",
        "first_name": "CARMEN",
        "middle_name": "MILLICENT",
        "name_prefix": "Mrs.",
        "credential": "ANP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NY",
            "license": "F305792-",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "000575-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enbal Baram, RPA-C
• Pamelia J Barclay, N.P.
• Alexander Barker
• Martha Barthelson, RN
• Charles Barthole, LPN
• Laurette Bastien, RN
• Amy Karol Baumgartner, LMHC, NCC, CASAC
• Douglas Bautista Sagastizado
• Bayview Rest Home, LLC
• Tatiana Ashley Bazelais, LMHC-D

• Adult Health Clinical Nurse Specialist in Babylon, NY
• Providers in Babylon, NY by specialty
• Adult Health Clinical Nurse Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.