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MR. ANDREW CLYDE BASS MEDICAL DOCTOR NPI 1912978693


NPI Information

NPI: 1912978693
Provider Name: MR. ANDREW CLYDE BASS, MEDICAL DOCTOR
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 10D0267042

Address:
315 SOUTH SCRIVEN AVE
LIVE OAK, FL
ZIP 32064
Phone: (386) 362-4822
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MR. Andrew Clyde Bass, MEDICAL DOCTOR is a general practice in Live Oak, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MR. Andrew Clyde Bass, MEDICAL DOCTOR NPI is 1912978693. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

315 SOUTH SCRIVEN AVE
LIVE OAK, FL
ZIP 32064
Phone: (386) 362-4822
Fax: (386) 364-3534

The NPI 1912978693 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 10D0267042 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Vaccine for influenza for injection into muscle (HCPCS:90662)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Hemoglobin a1c level (HCPCS:83036)
  • Urinalysis, manual test (HCPCS:81002)
  • Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)

The enumeration date for this NPI number is 1/30/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeME0017754FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D53063MEDICARE UPIN
216856OTHERFLORIDABCBS
316856MEDICARE ID-TYPE UNSPECIFIEDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.