Maryann Basista, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149 006503 Issued in IL

Practice address

1315 Butterfield Rd
Suite 220
Downers Grove, IL 60515-5602

Phone

(630) 788-8040

Fax

(630) 424-0425

NPI assigned

Aug 26, 2006

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 9

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371859200000",
    "number": "1902914476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 BUTTERFIELD RD",
            "address_2": "SUITE 220",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155602",
            "telephone_number": "630-788-8040",
            "fax_number": "630-424-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 BUTTERFIELD RD",
            "address_2": "SUITE 220",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155602",
            "telephone_number": "630-788-8040",
            "fax_number": "630-424-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASISTA",
        "first_name": "MARYANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-26",
        "last_updated": "2013-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149  006503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "813202000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "2167954",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7851779",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9426416",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "183695",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11713175",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "506974809",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2221790",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2567375",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kailani Marie Bartley
• Shannon Lyn Bartolucci, NP
• Basciano and Associates
• Marcia Basciano, DDS
• Kathryn Kellogg Basco
• Emaad Basith, MD
• Bastian Voice Institute, LLC
• Robert W Bastian, MD
• Zachary John Bastian, M.D.
• Koteswara Rao Batchu, M.D.

• Social Worker in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.