NPIMap

Individual provider Active NPI

Bassem M Eldaif, MD

  • Urology Physician
  • Melbourne, FL
National Provider Identifier
1881869089
Registry record updated Jul 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME101077 Issued in FL
Practice address
6032 Farcenda PL Ste 102
Melbourne, FL 32940
Phone
(321) 215-4799
Fax
(321) 252-4855
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME101077 FL Primary

Addresses

Primary practice location

6032 Farcenda PL Ste 102
Melbourne, FL 32940

Mailing address

2085 Highway A1A Apt 3301
Indian Harbour Beach, FL 32937-1804
Phone (954) 294-1963

Other identifiers 2

IdentifierTypeStateIssuer
000314200MedicaidFL
ME101077OtherFLFLORIDA MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000545 FL Practitioner - Urology 3173681905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Duke University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6032 Farcenda PL
Suite 102
Melbourne, FL 32940-7341
Phone (321) 215-4799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.47 of 100Reported as individual
Quality
88.94
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bassem Eldaif MD PA Urology CurrentSince Feb 21, 2018 Accepting new patients
Stewart and Stewart a Medical Corporation Past Accepting new patients

Locations

6032 Farcenda Pl
Ste 102
Melbourne, FL 32940
Phone (321) 215-4799

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532822400000",
    "number": "1881869089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 HIGHWAY A1A APT 3301",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329371804",
            "telephone_number": "954-294-1963",
            "fax_number": "866-683-6309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6032 FARCENDA PL STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-215-4799",
            "fax_number": "321-252-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDAIF",
        "first_name": "BASSEM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2018-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME101077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000314200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME101077",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.