Individual provider Active NPI

Anthony Gerard Bassanelli, MD

  • Psychiatry Physician
  • Palm Desert, CA
National Provider Identifier
1962469148
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G55820 Issued in CA
Practice address
44530 San Pablo Ave Ste 202
Palm Desert, CA 92260-3598
Phone
(760) 341-6026
Fax
(760) 341-6027
NPI assigned
Apr 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G55820 CA Primary

Addresses

Primary practice location

44530 San Pablo Ave Ste 202
Palm Desert, CA 92260-3598

Mailing address

44530 San Pablo Ave Ste 202
Palm Desert, CA 92260-3598
Phone (760) 341-6026

Other identifiers 2

IdentifierTypeStateIssuer
179072OtherNYMEDICAL LICENSE
G-55820OtherCAMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000192 CA Practitioner - Psychiatry 4385769413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Albany Medical College of Union University, 1984
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

44530 San Pablo Ave
Suite 202
Palm Desert, CA 92260-3598
Phone (760) 341-6026

Hospital & facility affiliations

  • San Gorgonio Memorial Hospital Hospital, Banning, CA, CCN 050054
  • Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G55820CAMDPsychiatry Physician
55820CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony G. Bassanelli, MD a Professional Corporation CurrentSince Sep 21, 2010 Accepting new patients
University Psychiatric Practice, Inc Psychiatry PastSince Oct 1, 1992 Accepting new patients
Eisenhower Medical Center Past Accepting new patients

Locations

44530 San Pablo Ave
Ste 202
Palm Desert, CA 92260
Phone (760) 341-6026

Organizations & group practices 3

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 2

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": "1146268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1962469148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44530 SAN PABLO AVE STE 202",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603598",
            "telephone_number": "760-341-6026",
            "fax_number": "760-341-6027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44530 SAN PABLO AVE STE 202",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603598",
            "telephone_number": "760-341-6026",
            "fax_number": "760-341-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSANELLI",
        "first_name": "ANTHONY",
        "middle_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-29",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G55820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "179072",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G-55820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.