NPIMap

Individual provider Active NPI

Matthew Peter Basara, MD

  • Internal Medicine Physician
  • Delran, NJ
National Provider Identifier
1972602191
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA57034 Issued in NJ
Practice address
5045 Route 130
Suite E
Delran, NJ 08075-9707
Phone
(856) 764-2525
Fax
(856) 764-6344
NPI assigned
Sep 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA57034 NJ Primary

Addresses

Primary practice location

5045 Route 130
Suite E
Delran, NJ 08075-9707

Mailing address

5045 Route 130
Suite E
Delran, NJ 08075-9707
Phone (856) 764-2525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050624000034 NJ Practitioner - Internal MedicinePractitioner - Family Practice 3779528302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5045 Route 130
Suite E
Delran, NJ 08075-9707
Phone (856) 764-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
26.7 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
88.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA57034NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delran Internal Medicine LLC Internal Medicine CurrentSince Oct 23, 1991 Accepting new patients

Locations

5045 Route 130
Ste E
Delran, NJ 08075
Phone (856) 489-0147

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972602191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5045 ROUTE 130",
            "address_2": "SUITE E",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080759707",
            "telephone_number": "856-764-2525",
            "fax_number": "856-764-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 ROUTE 130",
            "address_2": "SUITE E",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080759707",
            "telephone_number": "856-764-2525",
            "fax_number": "856-764-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASARA",
        "first_name": "MATTHEW",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA57034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delran, NJ

Sources for this page

Verify at the official NPI Registry.