Individual provider Active NPI

William Bernard Bass, ARNP

  • Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1790057859
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9193378 Issued in FL
Practice address
1801 SE Hillmoor Dr Ste B-105
Port St Lucie, FL 34952-7545
Phone
(772) 398-9911
Fax
(772) 398-4374
NPI assigned
Feb 6, 2012
Last updated
Sep 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ARNP9193378 FL
Adult Health Nurse Practitioner 363LA2200X 9193378 FL
Nurse Practitioner 363L00000X ARNP9193378 FL Primary

Addresses

Primary practice location

1801 SE Hillmoor Dr Ste B-105
Port St Lucie, FL 34952-7545

Mailing address

1801 SE Hillmoor Dr Ste B-105
Port St Lucie, FL 34952-7545
Phone (772) 398-9911

Other practice location 1

1916 Highway 441 North
Okeechobee, FL 34972
Phone (863) 357-7791

Other practice location 2

2100 Nebraska Ave Ste 203
Fort Pierce, FL 34950-4832
Phone (772) 464-6055

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
303015NYMDLicensed Practical Nurse
ARNP9193378FLMDOtolaryngology Physician
9193378FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC Otolaryngology PastSince Aug 28, 2023 Accepting new patients
DRS Berghash & Lanza PL Otolaryngology PastSince Apr 2, 2001 Accepting new patients

Organizations & group practices 2

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": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1790057859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE B-105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527545",
            "telephone_number": "772-398-9911",
            "fax_number": "772-398-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 SE HILLMOOR DR STE B-105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527545",
            "telephone_number": "772-398-9911",
            "fax_number": "772-398-4374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1916 Highway 441 North",
            "address_purpose": "LOCATION",
            "city": "Okeechobee",
            "state": "FL",
            "postal_code": "34972",
            "country_code": "US",
            "telephone_number": "863-357-7791",
            "fax_number": "863-357-6934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Nebraska Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349504832",
            "country_code": "US",
            "telephone_number": "772-464-6055",
            "fax_number": "772-464-2446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASS",
        "first_name": "WILLIAM",
        "middle_name": "BERNARD",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-06",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ARNP9193378",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9193378",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9193378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.