NPIMap

Individual provider Active NPI

Dev Aditya Gautam Basu, M.D.

  • Internal Medicine Physician
  • Towson, MD
National Provider Identifier
1821386228
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0079832 Issued in MD
Practice address
913 Southerly Road
#264
Towson, MD 21204-2629
Phone
(410) 275-9164
Fax
(410) 275-9164
NPI assigned
Jul 19, 2011
Last updated
Feb 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0079832 MD Primary

Addresses

Primary practice location

913 Southerly Road
#264
Towson, MD 21204-2629

Mailing address

913 Southerly Road
#264
Towson, MD 21204-2629
Phone (410) 275-9164

Other practice location 1

821 N Eutaw Street
Suite 308
Baltimore, MD 21201
Phone (410) 383-2072

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150917001875 MD Practitioner - Internal Medicine 9133363716 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavour Healthcare LLCGroup PAC ID 3072988815, 8 clinicians
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

135 N Parke St
Aberdeen, MD 21001-2428
Phone (443) 275-9164

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0079832MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavour Healthcare LLC Internal Medicine CurrentSince Feb 1, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jul 1, 2021 Accepting new patients
Medstar Medical Group II LLC Internal Medicine CurrentSince Jul 1, 2021 Accepting new patients
Elkton SNF LLC Past Accepting new patients
Endeavour Healthcare LLC Internal Medicine Past Accepting new patients
Endeavour Healthcare LLC Internal Medicine Past Accepting new patients
Rossville SNF Operations LLC Past Accepting new patients
Endeavour Healthcare LLC Internal Medicine Past Accepting new patients
Roland Park SNF Operations LLC Past Accepting new patients
Endeavour Healthcare LLC Internal Medicine Past Accepting new patients
Endeavour Healthcare LLC Internal Medicine Past Accepting new patients
Endeavour Healthcare LLC Internal Medicine Past Accepting new patients
Endeavour Healthcare LLC Internal Medicine Past Accepting new patients

Locations

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

4669 Falls Rd
Baltimore, MD 21209
Phone (410) 662-8606

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

1 Price Dr
Elkton, MD 21921
Phone (410) 398-6474

109 Forest Valley Dr
Forest Hill, MD 21050
Phone (410) 776-6038

1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440

7 Sudbrook Ln
Pikesville, MD 21208
Phone (410) 205-8440

1881 Telegraph Rd
Rising Sun, MD 21911
Phone (302) 290-3543

6600 Ridge Rd
Rosedale, MD 21237
Phone (410) 574-4950

111 West Rd
Towson, MD 21204
Phone (410) 828-6500

509 E Joppa Rd
Towson, MD 21286
Phone (301) 772-0484

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1821386228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 SOUTHERLY ROAD",
            "address_2": "#264",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042629",
            "telephone_number": "410-275-9164",
            "fax_number": "410-275-9164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 SOUTHERLY ROAD",
            "address_2": "#264",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042629",
            "telephone_number": "410-275-9164",
            "fax_number": "410-275-9164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 N Eutaw Street",
            "address_2": "Suite 308",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21201",
            "country_code": "US",
            "telephone_number": "410-383-2072",
            "fax_number": "410-383-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASU",
        "first_name": "DEV",
        "middle_name": "ADITYA GAUTAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0079832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.