Bassel Bardan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

39465 Issued in MN

Practice address

1216 Ryans Rd
Worthington, MN 56187-1722

Phone

(507) 372-2921

Fax

(507) 372-5789

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bassel.bardan@avera.sdhealthlink.net

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.

• Rural Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Worthington, MN
  • NPI 1215317375

  Pediatrics

  Medicare reassignment NPD
• Avera McKennan

  • Orthopaedic Surgery Physician
  • Sioux Falls, SD
  • NPI 1093262131

  MN

  Medicare reassignment NPD
• Rural Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Marshall, MN
  • NPI 1740944602
  NPD
• Sanford Health Network

  • Rural Acute Care Hospital
  • Worthington, MN
  • NPI 1396712618
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1831283456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 RYANS RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871722",
            "telephone_number": "507-372-2921",
            "fax_number": "507-372-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 RYANS RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871722",
            "telephone_number": "507-372-2921",
            "fax_number": "507-372-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDAN",
        "first_name": "BASSEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "39465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MPIN",
            "identifier": "54A03BA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "539817700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "370010988",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1909333",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "120955",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avera McKennan
• Avera McKennan
• Avera McKennan
• Naomi Noelle Bach
• Heather Lanae Bajema, PSY.D.
• Maria Del Rosario Barrera
• Karl W Beesch, MD
• Malea Beeson Stoesz
• Debra Kay Behrends, APRN CFPN
• Kristina Bergan

• Pediatrics Physician in Worthington, MN
• Providers in Worthington, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.