Individual provider Active NPI

Patricia Jeanne Basmajian, LCSW-R

  • Clinical Social Worker
  • Vestal, NY
National Provider Identifier
1780151456
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0441036-1 Issued in NY
Practice address
4102 Vestal Rd
Vestal, NY 13850-3531
Phone
(607) 772-1598
Fax
(607) 584-7679
NPI assigned
Oct 31, 2018
Last updated
Oct 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R0441036-1 NY Primary

Addresses

Primary practice location

4102 Vestal Rd
Vestal, NY 13850-3531

Mailing address

4102 Vestal Rd
Vestal, NY 13850-3531
Phone (607) 772-1598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0441036-1NYMDClinical Social Worker
041036NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1780151456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 VESTAL RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503531",
            "telephone_number": "607-772-1598",
            "fax_number": "607-584-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 VESTAL RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503531",
            "telephone_number": "607-772-1598",
            "fax_number": "607-584-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASMAJIAN",
        "first_name": "PATRICIA",
        "middle_name": "JEANNE",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0441036-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.