Active NPI
Gabriel Basantes
- Physician Assistant
- Maspeth, NY
National Provider Identifier
1811530652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 027079
- Practice address
- 6084 Mount Olivet Cres
Maspeth, NY 11378-3451 - Phone
- (347) 693-3695
- NPI assigned
- Oct 24, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 027079 | NY | Primary |
Addresses
Primary practice location
6084 Mount Olivet Cres
Maspeth, NY 11378-3451
Mailing address
6084 Mount Olivet Cres
Maspeth, NY 11378-3451
Phone (347) 693-3695
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230315001674 | NY | Practitioner - Physician Assistant | 1355715228 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Icahn School of Medicine at Mount Sinai
Practice addresses (Care Compare)
5 E 98TH St
New York, NY 10029-6501
Phone (212) 241-0045
One Gustave L Levy Place
New York, NY 10029-6574
Phone (212) 241-0045
Hospital & facility affiliations
- Mount Sinai Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027079 | NY | MD | Physician Assistant |
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Past | Accepting new patients |
Locations
5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234
150 E 42nd St
Fl 2
New York, NY 10017
Phone (646) 605-8119
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Organizations & group practices 3
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.
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- NPI 1760227466
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- New York, NY
- NPI 1124392212
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1811530652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6084 MOUNT OLIVET CRES",
"city": "MASPETH",
"state": "NY",
"postal_code": "113783451",
"telephone_number": "347-693-3695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6084 MOUNT OLIVET CRES",
"city": "MASPETH",
"state": "NY",
"postal_code": "113783451",
"telephone_number": "347-693-3695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASANTES",
"first_name": "GABRIEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-24",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "027079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maspeth, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; 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.