Paul B Bascom MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD16983 Issued in OR

Legal business name

PAUL B BASCOM MD LLC

Practice address

94220 4TH St
Gold Beach, OR 97444-7756

Phone

(503) 961-2017

NPI assigned

Apr 25, 2014

Organization subpart

No

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

Authorized official

Name

Paul B Bascom, M.D.NPI 1689680134

Title

Owner

Phone

(503) 961-2017

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Benjamin Bascom, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Gold Beach, OR
  • NPI 1689680134
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1710307046",
    "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": "503-961-2017"
        },
        {
            "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": "503-961-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL B BASCOM MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "BASCOM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-961-2017",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD16983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Jean Nerio, LMFT
• Oregon Retina, LLP
• Elissa A. Parkerson
• Marshall Patterson
• Paul B Bascom MD
• Anicia Jann Peltzer
• Viridiana Penaloza
• Noel C Pense, D.O.
• Bruce E. Perry, MD
• Merna Peterson

• Internal Medicine Physician in Gold Beach, OR
• Providers in Gold Beach, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.