NPIMap

Organization Active NPI

Mauricio D. Bas, Jr., M.D., P.C.

  • Vascular Surgery Physician
  • Woodbridge, VA
National Provider Identifier
1912028531
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0101022428 Issued in VA
Legal business name
MAURICIO D. BAS, JR., M.D., P.C.
Practice address
1970 Opitz Blvd
Woodbridge, VA 22191-3304
Phone
(703) 494-8174
NPI assigned
Apr 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mauricio D Bas Jr., M.D.NPI 1437247756
Title
President
Phone
(703) 494-8174

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0101022428 VA Primary

Addresses

Primary practice location

1970 Opitz Blvd
Woodbridge, VA 22191-3304

Mailing address

PO Box 4806
Woodbridge, VA 22194-4806
Phone (703) 580-5580

Other identifiers 2

IdentifierTypeStateIssuer
249067OtherVAANTHEM BLUE CROSS
7449569MedicaidVA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912028531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4806",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221944806",
            "telephone_number": "703-580-5580",
            "fax_number": "703-580-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913304",
            "telephone_number": "703-494-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICIO D. BAS, JR., M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAS",
        "authorized_official_first_name": "MAURICIO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-494-8174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101022428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "249067",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7449569",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.