DR. FAWZY SAMY BASTA SR. MD
NPI 1043394505
Psychiatry & Neurology - Psychiatry in Northridge, CA
About Dr. Fawzy Samy Basta Sr. Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. FAWZY SAMY BASTA SR. MD (NPI 1043394505) is an individual psychiatry provider in Northridge, California, licensed in California (A42961) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1978).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Fawzy Samy Basta Sr. Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Fawzy Basta reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Northridge, CA 91325
- Reassigned Medicare billing, California enrollment
- 5 clinicians in this Medicare group
North Hills, CA 91343
- Reassigned Medicare billing, California enrollment
- 146 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 10
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91325 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NORTHRIDGE, CA 91325
NORTHRIDGE, CA 91325
NORTHRIDGE, CA 91325
NORTHRIDGE, CA 91325
NORTHRIDGE, CA 91325
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 Fawzy Basta's NPI number?
The NPI number for Fawzy Basta is 1043394505. It was assigned to this individual provider in the NPPES registry on October 24, 2006.
Where is Fawzy Basta located?
Fawzy Basta practices at 17075 Devonshire St Ste 204, Northridge, CA 91325. The listed phone number is (818) 368-8929.
What is Fawzy Basta's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.
Is Fawzy Basta enrolled in Medicare?
Yes. Fawzy Basta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Fawzy Basta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Fawzy Basta reassigns Medicare benefits to 2 organizations: Fawzy Basta M D A Professional Corporation (Northridge, CA) and Mission City Community Network, Inc. (North Hills, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Fawzy Basta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Fawzy Basta was last updated on January 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Dr. Fawzy Samy Basta Sr., MD · NPI 1043394505
Psychiatry physician in Northridge, California. Individual provider, active in the CMS NPPES registry since October 24, 2006.
## Identity
- **NPI:** 1043394505 (Entity type: Individual)
- **Enumerated:** October 24, 2006
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **State license:** A42961 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 17075 DEVONSHIRE ST, STE 204, Northridge, CA 91325-5408
- **Phone:** (818) 368-8929 · **Fax:** (818) 368-8940
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Fawzy Basta M D A Professional Corporation (NPI 1508932500, Northridge, CA); Mission City Community Network, Inc. (NPI 1710370747, North Hills, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1978
## Record status
- **NPPES last updated:** January 20, 2012
- **Other identifiers:** Medicaid 0A429611 (CA); Medicare UPIN B50502; Medicare PIN W11809A
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Source: [NPI Profile](https://npiprofile.com/npi/1043394505) · Data from the CMS NPPES public registry.