Sameh Basta, M.D

Individual provider Active NPI Family Medicine Physician · Middletown, DE

NPI 1922414978 · NPPES record last updated Jun 10, 2022

Key facts

NPI
1922414978
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
A175282 (CA)
Practice address
651 N Broad St Ste 206
Middletown, DE 19709-6402
Phone
(312) 459-0921
NPI assigned
Jul 9, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220516002700 CA Practitioner - Family Practice 8820475668 Practice locations: Sacramento, CA

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A175282CAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X A175282 CA Yes

Addresses

Primary practice location

651 N Broad St Ste 206
Middletown, DE 19709-6402

Mailing address

425 Michigan Ave
Buffalo, NY 14203-2209

Other practice location 1

425 Michigan Ave
Buffalo, NY 14203-2209
Phone (312) 459-0921

Other providers in Middletown, DE

All providers in Middletown, DE · Family Medicine Physician in Delaware

Sources for this page

Verify at the official NPI Registry.