Individual provider Active NPI

Bassem M Demian, DPM

  • Podiatrist
  • Brick, NJ
National Provider Identifier
1710957733
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00215100 Issued in NJ
Practice address
292 Herbertsville Rd
Brick, NJ 08724-1734
Phone
(732) 840-8989
NPI assigned
Jan 23, 2006
Last updated
Jan 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00215100 NJ Primary
Foot Surgery Podiatrist 213ES0131X 25MD00215100 NJ

Addresses

Primary practice location

292 Herbertsville Rd
Brick, NJ 08724-1734

Mailing address

292 Herbertsville Rd
Brick, NJ 08724-1734
Phone (732) 840-8989

Other identifiers 1

IdentifierTypeStateIssuer
5549604MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060406000026 NJ Practitioner - Podiatry 5890704605 Reassigns benefits to 1 organization
Practice locations: Brick, NJ; Manasquan, NJ; Lakewood, NJ
I20210803000057 FL Practitioner - Podiatry 5890704605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adnan Shariff IncGroup PAC ID 3375682545, 6 clinicians

Practice addresses (Care Compare)

235 NE 19TH Dr
Okeechobee, FL 34972-1933
Phone (863) 357-1166

Merit-based Incentive Payment System (MIPS)

Final score
81.93 of 100Reported as individual
Quality
57.02
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions41
Removal of nail tissue1630
Removal or shaving of skin growth1133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00215100NJMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brick Foot & Ankle Center, PC Podiatrist CurrentSince May 10, 2019 Accepting new patients
Adnan Shariff, Inc Podiatrist CurrentSince Jul 1, 2021 Accepting new patients
Adnan Shariff, Inc Podiatrist CurrentSince Jul 1, 2021 Accepting new patients
Adnan Shariff DPM PLLC Past Accepting new patients

Locations

7050 W Palmetto Park Rd
Ste 18
Boca Raton, FL 33433
Phone (561) 391-8366

1008 W Sagamore Ave
Clewiston, FL 33440
Phone (863) 983-1103

235 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-1166

292 Herbertsville Rd
Brick, NJ 08724
Phone (732) 840-8989

Interoperability endpoints

  • Direct secure messaging: bassem.demian.1@19322.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19322/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1710957733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 HERBERTSVILLE RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087241734",
            "telephone_number": "732-840-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 HERBERTSVILLE RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087241734",
            "telephone_number": "732-840-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIAN",
        "first_name": "BASSEM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00215100",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "25MD00215100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5549604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.