Basirat Romoke Bale, APN, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209014251 Issued in IL

Practice address

5841 S Maryland Ave
Chicago, IL 60637-1443

Phone

(773) 834-4946

Fax

(773) 834-2058

NPI assigned

Nov 18, 2016

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

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southerncare, Inc.Group PAC ID 8527977735, 9 clinicians

Ih Physician Services PCGroup PAC ID 5991165458, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bbale191404@uchospital.direct-ci.com

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.

• Ih Physician Services, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Buffalo Grove, IL
  • NPI 1790566206
  Medicare reassignment Care Compare group NPD
• Ih Physician Services, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Knoxville, TN
  • NPI 1770469389
  NPD
• Southerncare, Inc.

  • Community Based Hospice Care Agency
  • Chadds Ford, PA
  • NPI 1275232795
  NPD

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593734400000",
    "number": "1962945261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9745 S KARLOV AVE",
            "address_2": "APT. 203",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533389",
            "telephone_number": "708-299-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "773-834-4946",
            "fax_number": "773-834-2058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9745 S Karlov Ave",
            "address_2": "APT. 203",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604533389",
            "country_code": "US",
            "telephone_number": "708-299-3064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALE",
        "first_name": "BASIRAT",
        "middle_name": "ROMOKE",
        "credential": "APN, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Baldwin, AMFT
• Kerri Keller Baldwin, APN
• Larry Edward Baldwin, PH.D
• Meghan Elizabeth Baldwin, APN
• Rosemary Jeanette Baldwin, CNM
• Angela Bales, PSY.D.
• Cayla Elizabeth Bales, MD
• Gregory Bales
• Melissa Rose Bales, BSN, RN
• Rena Balesh, MHP

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; 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.