Patricia Marie Bass, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R058561-1 Issued in NY

Practice address

341 Jayne Blvd
Port Jefferson Station, NY 11776-2971

Phone

(631) 928-6565

Fax

(631) 928-6565

NPI assigned

Dec 6, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, NC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1871776443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 JAYNE BLVD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762971",
            "telephone_number": "631-928-6565",
            "fax_number": "631-928-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 JAYNE BLVD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762971",
            "telephone_number": "631-928-6565",
            "fax_number": "631-928-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R058561-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02068019",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2069458",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Sheffield Barnes, CRNP
• Douglas Barnett, LPN
• Marjorie Bartholomew, MA
• Mary Barto, L.M.T.
• Laurajean Basile
• Angie Margareth Batres-Perez
• Dawn Battaglia
• Brenden M Batton
• Sophie Farah Beausoleil
• Brandi Beere, NP

• Clinical Social Worker in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.