Individual provider Active NPI

Milo Bastianelli, DO

  • Otolaryngology/Facial Plastic Surgery Physician
  • Delray Beach, FL
National Provider Identifier
1811937048
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
OS16264 Issued in FL
Practice address
13660 S Jog Rd Ste 3
Delray Beach, FL 33446-3806
Phone
(561) 495-2002
Fax
(561) 733-3742
NPI assigned
Jun 7, 2006
Last updated
Feb 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 25MB06532600 NJ
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X OS16264 FL Primary
Orthopaedic Surgery Physician 207X00000X 25MB06532600 NJ
Facial Plastic Surgery Physician 207YS0123X 25MB06532600 NJ

Addresses

Primary practice location

13660 S Jog Rd Ste 3
Delray Beach, FL 33446-3806

Mailing address

13660 S Jog Rd Ste 3
Delray Beach, FL 33446-3806
Phone (561) 495-2002

Other practice location 1

505 Chestnut Street
Roselle Park, NJ 07204
Phone (908) 241-0200 ext. 15

Other identifiers 2

IdentifierTypeStateIssuer
854041OtherNJAETNA
OS162264OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190819001061 FL Practitioner - Otolaryngology 5395748420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Rowan University School of Osteopathic Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Ear, Nose, and Throat, P.a.Group PAC ID 2062690092, 2 clinicians

Practice addresses (Care Compare)

13660 Jog Rd
Suite 3
Delray Beach, FL 33446-3806
Phone (561) 495-2002

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB06532600NJMDOrthopaedic Surgery Physician
OS16264FLMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Platinum Ear, Nose, and Throat, P.a. Otolaryngology/Facial Plastic Surgery CurrentSince Sep 1, 2019 Accepting new patients
Ijkg Opco LLC Current Accepting new patients
Fidelity Hearing Health, LLC PastSince Sep 15, 1997 Accepting new patients
FL Gator ENT PLLC Otolaryngology/Facial Plastic Surgery PastSince Sep 1, 2019 Accepting new patients

Locations

13660 S Jog Rd
Ste 3
Delray Beach, FL 33446
Phone (561) 495-2002

Interoperability endpoints

  • Direct secure messaging: milo.bastianelli@direct.bayonnemedicalcenter.md

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1811937048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 S JOG RD STE 3",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334463806",
            "telephone_number": "561-495-2002",
            "fax_number": "561-733-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 S JOG RD STE 3",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334463806",
            "telephone_number": "561-495-2002",
            "fax_number": "561-733-3742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Chestnut Street",
            "address_purpose": "LOCATION",
            "city": "Roselle Park",
            "state": "NJ",
            "postal_code": "07204",
            "country_code": "US",
            "telephone_number": "908-241-0200 x15",
            "fax_number": "908-241-1615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASTIANELLI",
        "first_name": "MILO",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NJ",
            "license": "25MB06532600",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "OS16264",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MB06532600",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NJ",
            "license": "25MB06532600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "854041",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OS162264",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.