Bassil Mazen Kublaoui, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

MD438428 Issued in PA

Practice address

3401 Civic Center Blvd
Children'S Hospital of Philadelphia - Endocrinology
Philadelphia, PA 19104-4319

Phone

(215) 590-3174

Fax

(215) 590-3053

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Endocrinology

Education

Boston University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Childrens Health Care Associates IncGroup PAC ID 1355253527, 211 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Childrens Health Care Associates, Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1598869059
  Medicare reassignment Care Compare group NPD
• Childen'S Health Care Associates Inc.

  • Pediatric Registered Nurse
  • Philadelphia, PA
  • NPI 1699860643
  NPD
• Childrens Health Care Associates, Inc

  • Pediatric Endocrinology Physician
  • Philadelphia, PA
  • NPI 1275628224
  NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  NPD (past)

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1881654549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9234",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "CHILDREN'S HOSPITAL OF PHILADELPHIA - ENDOCRINOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-3174",
            "fax_number": "215-590-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBLAOUI",
        "first_name": "BASSIL",
        "middle_name": "MAZEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "TX",
            "license": "L4024",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "PA",
            "license": "MD438428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149928710",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita Ann Kubicky, MD
• Jennifer Kubinski, OTR/L
• Kevin Kubinski, DPT
• Elizabeth Kubis
• Hana Kubkova
• Brian T Kucer, MD
• Colleen Renee Kucharczuk, CRNP
• John C Kucharczuk, MD
• Katheryn Kucharski
• Timothy James Kuchera, M.D.

• Pediatric Endocrinology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Endocrinology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.