Individual provider Active NPI

Jaime Y Basnillo, MD

  • Psychiatry Physician
  • Medical Lake, WA
National Provider Identifier
1700869419
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD00022233 Issued in WA
Practice address
800 West Maple Street
Medical Lake, WA 99022-0800
Phone
(509) 299-3121
Fax
(509) 299-7015
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD00022233 WA Primary

Addresses

Primary practice location

800 West Maple Street
Medical Lake, WA 99022-0800

Mailing address

800 West Maple Street
P O Box 800
Medical Lake, WA 99022-0800
Phone (509) 299-3121

Other identifiers 1

IdentifierTypeStateIssuer
8142036MedicaidWA

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
I20101118001347 WA Practitioner - Psychiatry 7517153331 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00022233WAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Social Dept of SHS Div of Instns Psychiatry CurrentSince Aug 4, 1992 Accepting new patients
Department of Social Past Accepting new patients
Eastern State Hospital Pharmacy Past Accepting new patients

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700869419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WEST MAPLE STREET",
            "address_2": "P O BOX 800",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-299-3121",
            "fax_number": "509-299-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST MAPLE STREET",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-299-3121",
            "fax_number": "509-299-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASNILLO",
        "first_name": "JAIME",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD00022233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8142036",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medical Lake, WA

Sources for this page

Verify at the official NPI Registry.