Individual provider Active NPI

Virginia M Bazis, M.ED

  • Mental Health Counselor
  • Philadelphia, PA
National Provider Identifier
1861643306
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC003060 Issued in PA
Practice address
833 Chestnut St
Suite 210
Philadelphia, PA 19107-4414
Phone
(215) 955-7698
NPI assigned
Oct 2, 2008
Last updated
Oct 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC003060 PA Primary

Addresses

Primary practice location

833 Chestnut St
Suite 210
Philadelphia, PA 19107-4414

Mailing address

833 Chestnut St
Suite 210
Philadelphia, PA 19107-4414
Phone (215) 955-7698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412000851 PA Practitioner - Mental Health Counselor 9739343773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

33 S 9TH St
210 Jefferson Dept of Psychiatry
Philadelphia, PA 19107-4408
Phone (215) 955-8420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
PC003060PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Feb 7, 2024 Accepting new patients

Locations

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

833 Chestnut St
Ste 210
Philadelphia, PA 19107
Phone (215) 955-5638

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

Organizations & group practices 1

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": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1861643306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST",
            "address_2": "SUITE 210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-955-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZIS",
        "first_name": "VIRGINIA",
        "middle_name": "M",
        "credential": "M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC003060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.