1. Home
  2. Directory
  3. New York
  4. Brooklyn
  5. Pediatrics
  6. NPI Profile

NISSIM BASSOUL MD
NPI 1023071701
Pediatrics in Brooklyn, NY

Active since April 11, 2006PECOS EnrolledCLIA 33D2160005 · Waiver
2490 OCEAN PKWY, BROOKLYN, NY 11235(718) 496-4607(718) 382-1920 Get Directions Write a Review

NPPES record last updated: January 10, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 10, 2022, Mar 3, 2016 (2 updates tracked since 2016).

About Nissim Bassoul Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NISSIM BASSOUL MD (NPI 1023071701) is an individual pediatrics provider in Brooklyn, New York, licensed in New York (1861601) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and holds a CLIA Waiver certificate valid through January 2, 2027.

NPPES Registry Identity

NPI1023071701
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameNISSIM BASSOULCredential: MD
Location Address2490 OCEAN PKWYBrooklyn, NY 11235-6132
Mailing Address2490 Ocean PkwyBrooklyn, NY 11235-6132 · (718) 496-4607 · Fax (718) 382-1920
Phone(718) 496-4607
Fax(718) 382-1920
Sole ProprietorNo
Enumeration DateApril 11, 2006
Last NPPES UpdateJanuary 10, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 10, 2022
✔ NPI 1023071701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 1861601
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2490 OCEAN PKWY, Brooklyn, NY 11235
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nissim Bassoul Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2160005

Nissim Bassoul · Brooklyn, NY
Active · expires Jan 2, 2027
CLIA Number33D2160005
Laboratory TypePhysician Office
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorDr. Nissim Bassoul
Laboratory Phone(718) 382-1920
Laboratory LocationNissim Bassoul2490 Ocean Parkway, Brooklyn, NY 11235
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11235 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nissim Bassoul's NPI number?

The NPI number for Nissim Bassoul is 1023071701. It was assigned to this individual provider in the NPPES registry on April 11, 2006.

Where is Nissim Bassoul located?

Nissim Bassoul practices at 2490 Ocean Pkwy, Brooklyn, NY 11235. The listed phone number is (718) 496-4607.

What is Nissim Bassoul's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Nissim Bassoul enrolled in Medicare?

Yes. Nissim Bassoul is registered in the Medicare PECOS enrollment system.

Does Nissim Bassoul hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2160005) is associated with this NPI, valid through January 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Nissim Bassoul was last updated on January 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.