Individual provider Active NPI

Danielle L Basurco, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1871893040
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A122293 Issued in CA
Practice address
808 W 58TH St
Los Angeles, CA 90037-3632
Phone
(323) 541-1660
Fax
(323) 541-1499
NPI assigned
Oct 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A122293 CA Primary

Addresses

Primary practice location

808 W 58TH St
Los Angeles, CA 90037-3632

Mailing address

107 S Croft Ave
7
Los Angeles, CA 90048-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130805000450 CA Practitioner - Family Practice 0648412601 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Mar 19, 2018 Accepting new patients
St. Johns Community Health CurrentSince Dec 26, 2016 Accepting new patients
St. Johns Community Health CurrentSince Dec 26, 2016 Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Mar 19, 2018 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

1555 W 110th St
Los Angeles, CA 90047
Phone (323) 757-2771

7301 Medical Ctr
Ste 500
West Hills, CA 91307
Phone (818) 226-1211

Interoperability endpoints

  • Direct secure messaging: danielle.basurco.1@17371.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1871893040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S CROFT AVE",
            "address_2": "7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900483422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W 58TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900373632",
            "telephone_number": "323-541-1660",
            "fax_number": "323-541-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASURCO",
        "first_name": "DANIELLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A122293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.