JACK ELLIOTT BASSE MD
NPI 1083300669
Emergency Medicine in Los Angeles, CA
About Jack Elliott Basse Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACK ELLIOTT BASSE MD (NPI 1083300669) is an individual emergency medicine provider in Los Angeles, California, licensed in California (1083300669) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of Washington University School Of Medicine (2023).
NPPES Registry Identity
Specialties & Licenses
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
Jack Elliott Basse 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 Reassignment
Medicare enrollment records show Jack Basse reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Santa Monica, CA 90405
- Reassigned Medicare billing, California enrollment
- 1,939 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90095 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
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 Jack Basse's NPI number?
The NPI number for Jack Basse is 1083300669. It was assigned to this individual provider in the NPPES registry on April 17, 2023.
Where is Jack Basse located?
Jack Basse practices at 757 Westwood Plz, Los Angeles, CA 90095. The listed phone number is (310) 794-0785.
What is Jack Basse's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Jack Basse enrolled in Medicare?
Yes. Jack Basse 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 organization bills Medicare for Jack Basse's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jack Basse reassigns Medicare benefits to County Of Los Angeles (Santa Monica, CA). The 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 Jack Basse'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 Jack Basse was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Jack Elliott Basse, MD · NPI 1083300669
Emergency Medicine physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since April 17, 2023.
## Identity
- **NPI:** 1083300669 (Entity type: Individual)
- **Enumerated:** April 17, 2023
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 1083300669 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 757 WESTWOOD PLZ, Los Angeles, CA 90095-8358
- **Phone:** (310) 794-0785
## 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:** County Of Los Angeles (NPI 1235323080, Santa Monica, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Washington University School Of Medicine, class of 2023
## Record status
- **NPPES last updated:** June 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1083300669) · Data from the CMS NPPES public registry.