Jay B Basillote (NPI# 1245202555, PAC ID# 0244122232) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1245202555 |
| PAC ID by PECOS | 0244122232 |
| Professional Enrollment ID | I20040325001087 |
| Full Name | Jay B Basillote |
| Organization Legal Name | SOVEREIGN MEDICAL GROUP LLC |
| Address |
2071 Clove Rd J Staten Island NY 10304-1612 |
| Phone Number | 2018558301 |
| Gender | M |
| Credential | MD |
| Medical School | STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER |
| Graduation Year | 1995 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 1456535392 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330160 | STATEN ISLAND UNIVERSITY HOSPITAL |
| 330028 | RICHMOND UNIVERSITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2071 Clove Rd J, Staten Island, NY 10304-1612 | 2018558301 | SOVEREIGN MEDICAL GROUP LLC |
| Organization Legal Name | SOVEREIGN MEDICAL GROUP LLC |
| Physicians | 41 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen M Bellapianta | Otolaryngology | Sovereign Medical Group LLC | 85 Harristown, Suite 105, Glen Rock, NJ 07452-3307 |
| Raffaella L Kalishman | Internal Medicine | Sovereign Medical Group LLC | 85 Harristown Rd, Suite 104, Glen Rock, NJ 07452-3323 |
| Elliot L Shulman | Urology | Sovereign Medical Group LLC | 807 Kennedy Blvd, Suite A, Bayonne, NJ 07002-2983 |
| Albert O Kwon | Colorectal Surgery (proctology) | Sovereign Medical Group LLC | 15-01 Broadway Route 4 W, Suite 1, Fairlawn, NJ 07410-6006 |
| Andranik Howhannesian | Urology | Sovereign Medical Group LLC | 14 -01 Broadway, Suite 3, Fair Lawn, NJ 07410-2008 |
| Jerry Silver | Otolaryngology | Sovereign Medical Group LLC | 15 -01 Broadway Rt 4, Fairlawn, NJ 07410-6006 |
| Joel Abramowitz | Urology | Sovereign Medical Group LLC | 8100 Kennedy Blvd, North Bergen, NJ 07047-4254 |
| Richard Maggio | Urology | Sovereign Medical Group LLC | 2071 Clove Rd J, Staten Island, NY 10304-1612 |
| Scott A Goler | Podiatry | Sovereign Medical Group LLC | 265 E 33rd St, Paterson, NJ 07504-1668 |
| Morteza Shahamat | Internal Medicine | Sovereign Medical Group LLC | 400 Franklin Tpke, Suite 104, Mahwah, NJ 07430-3517 |
| Street Address |
2071 CLOVE RD J |
| City | STATEN ISLAND |
| State | NY |
| Zip | 10304-1612 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard Maggio | Urology | Sovereign Medical Group LLC | 2071 Clove Rd J, Staten Island, NY 10304-1612 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lucy R Sarkis | Psychiatry | 60 Romer Rd, Staten Island, NY 10304-1227 | |
| Seth L Golden | Podiatry | Preferred Family Footcare of Li Pllc | 801 Narrows N Rd, Staten Island, NY 10304-1500 |
| Jonathan Klein | Podiatry | Preferred Family Footcare of Li Pllc | 801 Narrows N Rd, Staten Island, NY 10304-1500 |
| George J Ayyad | Internal Medicine | 1800 Clove Rd, Staten Island, NY 10304-1600 | |
| Lucy S Kolloori | Psychiatry | Kolloori and Kolloori Physicians LLC | 1800 Clove Rd, Staten Island, NY 10304-1600 |
| Benjamin J Kolloori | Internal Medicine | Kolloori and Kolloori Physicians LLC | 1800 Clove Rd, Staten Island, NY 10304-1600 |
| Sunil H Patel | Gastroenterology | 1800 Clove Rd, Staten Island, NY 10304-1600 | |
| Angelo F Contino | Psychologist, Clinical | 183 Willow Rd E, Staten Island Nyc, NY 10304-1612 | |
| Isaac J Kreizman | Physical Medicine and Rehabilitation | Pars Medical PC | 2071 Clove Rd, Staten Island, NY 10304-1612 |
| S Ramachandran Nair | Internal Medicine | 2071 Clove Rd, Staten Island, NY 10304-1612 | |
| Find all physicians in zip 10304 | |||
| City | STATEN ISLAND |
| Zip Code | 10304 |
| Specialty | UROLOGY |
| City + Specialty | STATEN ISLAND + UROLOGY |
Please comment or provide details below to improve the information on Jay B Basillote.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.