NPIMap

Individual provider Active NPI

Pablo Javier Bassuk, M.D.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1972625069
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A99057 Issued in CA
Practice address
1509 Wilson Ter
Glendale, CA 91206-4007
Phone
(747) 273-1129
Fax
(818) 356-4465
NPI assigned
Apr 6, 2007
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A99057 CA Primary

Addresses

Primary practice location

1509 Wilson Ter
Glendale, CA 91206-4007

Mailing address

PO Box 2027
Glendale, CA 91209-2027
Phone (323) 943-8577

Other identifiers 1

IdentifierTypeStateIssuer
1972625069MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070625000469 CA Practitioner - Family Practice 3870692379 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pablo Bassuk M D IncGroup PAC ID 3072828813, 2 clinicians

Practice addresses (Care Compare)

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (747) 273-1129

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99057CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vahe Akopian MD Inc CurrentSince Apr 1, 2025 Accepting new patients
Cognacare Neurologic, Inc CurrentSince Apr 1, 2025 Accepting new patients
York Healthcare & Wellness Centre, LP PastSince Jul 1, 2016 Accepting new patients

Locations

1451 E Chevy Chase Dr
Ste 201
Glendale, CA 91206
Phone (818) 265-2245

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rockport Healthcare ServicesLos Angeles, CA, CCN 055664 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2016
Jul 1, 2016
College Vista Post-AcuteLos Angeles, CA, CCN 555030 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2021
Jan 1, 2021
Compassion Home Health Care IncReseda, CA, CCN 559566 Home health agency Operational/Managerial Control Jun 15, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1972625069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2027",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912092027",
            "telephone_number": "323-943-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "747-273-1129",
            "fax_number": "818-356-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSUK",
        "first_name": "PABLO",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A99057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972625069",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.