Active NPI
Ethan Christopher Bassett, M.D.
- Pediatric Otolaryngology Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Otolaryngology Physician
- License
- 87457-20
- Practice address
- 9200 W Wisconsin Ave
Milwaukee, WI 53226-3522 - Phone
- (414) 805-5580
- Fax
- (414) 476-4701
- NPI assigned
- Apr 12, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Otolaryngology Physician | 207YP0228X | 87457-20 | WI | Primary |
Addresses
Primary practice location
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Mailing address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-5580
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710277769 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- University of Maryland School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35130618 | OH | MD | Pediatric Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| University of Minnesota Health Clinics and Surgery Center, Inc. | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| University of Minnesota Health Clinics and Surgery Center Inc | Current | Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| Fairview Specialty Services | Current | Accepting new patients | |
| Fairview Health Services | Past | Accepting new patients |
Locations
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
701 25th Ave S
Ste 200
Minneapolis, MN 55454
Phone (612) 339-2836
909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383
Interoperability endpoints
- ebassett838652@fairview.direct-ci.com
Organizations & group practices 9
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- Clinic/Center
- Minneapolis, MN
- NPI 1053795187
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- Point of Service
- Saint Paul, MN
- NPI 1912066218
-
- Anesthesiology Physician
- Minneapolis, MN
- NPI 1003485004
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1730586819
-
- Dental Clinic/Center
- Minneapolis, MN
- NPI 1952546061
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1013994359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1710277769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-5580",
"fax_number": "414-476-4701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532263522",
"telephone_number": "414-805-5580",
"fax_number": "414-476-4701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASSETT",
"first_name": "ETHAN",
"middle_name": "CHRISTOPHER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-12",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "WI",
"license": "87457-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1710277769",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.