Individual provider Active NPI

Carol Bass, MS

  • Audiologist
  • Ithaca, NY
National Provider Identifier
1922145341
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0004501 Issued in NY
Practice address
200 Pleasant Grove Rd
Ithaca, NY 14850-2664
Phone
(607) 257-3903
Fax
(607) 266-8821
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X 0004501 NY Primary

Addresses

Primary practice location

200 Pleasant Grove Rd
Ithaca, NY 14850-2664

Mailing address

200 Pleasant Grove Rd
Ithaca, NY 14850-2664
Phone (607) 257-3903

Other identifiers 1

IdentifierTypeStateIssuer
TF6975007OtherNYTAX PAYER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0004501NYMDAudiologist
000450NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1922145341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PLEASANT GROVE RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502664",
            "telephone_number": "607-257-3903",
            "fax_number": "607-266-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PLEASANT GROVE RD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148502664",
            "telephone_number": "607-257-3903",
            "fax_number": "607-266-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "CAROL",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "NY",
            "license": "0004501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX PAYER ID",
            "identifier": "TF6975007",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.