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Individual provider Active NPI

Paul Benjamin Bascom, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Gold Beach, OR
National Provider Identifier
1689680134
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
G061983 Issued in OR
Practice address
94220 4TH St
Gold Beach, OR 97444-7756
Phone
(702) 453-3799
Fax
(702) 453-5741
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X G061983 OR Primary

Addresses

Primary practice location

94220 4TH St
Gold Beach, OR 97444-7756

Mailing address

2660 Crimson Canyon Dr Ste 130
Las Vegas, NV 89128-0846
Phone (702) 453-3799

Other identifiers 1

IdentifierTypeStateIssuer
040563MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140428001230 OR Practitioner - Internal MedicinePractitioner - Other (Physician) 7517926157 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1000 3Rd St
Tillamook, OR 97141-3430
Phone (503) 842-4444

94220 4TH St
Gold Beach, OR 97444-7756
Phone (541) 247-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G061983ORMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC CurrentSince May 1, 2017 Accepting new patients
Curry Health District CurrentSince Apr 14, 2014 Accepting new patients
Curry Health District Hospice and Palliative Medicine CurrentSince Apr 14, 2014 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jul 1, 2025 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Jul 1, 2025 Accepting new patients
S Pannu Inc Past Accepting new patients

Locations

94220 4th St
Gold Beach, OR 97444
Phone (541) 247-3000

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

Interoperability endpoints

  • Direct secure messaging: pbascom@yourcarecommunity.org

Organizations & group practices 10

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 5

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1689680134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 CRIMSON CANYON DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280846",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94220 4TH ST",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "974447756",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCOM",
        "first_name": "PAUL",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "G061983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040563",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Beach, OR

Sources for this page

Verify at the official NPI Registry.