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KEITH EMORY BASHAM PHYSICIAN ASSISTANT
NPI 1124329339
Physician Assistant in Albuquerque, NM

Active since November 04, 2010PECOS EnrolledAccepts Medicare Assignment
7704 2ND ST NW STE A, ALBUQUERQUE, NM 87107(505) 873-7400 Get Directions Write a Review

NPPES record last updated: May 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 16, 2025, Sep 17, 2024 (2 updates tracked since 2024).

About Keith Emory Basham Physician Assistant NPPES

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

KEITH EMORY BASHAM PHYSICIAN ASSISTANT (NPI 1124329339) is an individual physician assistant in Albuquerque, New Mexico, licensed in New Mexico (PA2011-0057) and active in the NPI registry since November 2010. He is enrolled in Medicare PECOS, is affiliated with Lovelace Women's Hospital, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1124329339
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameKEITH EMORY BASHAMCredential: PHYSICIAN ASSISTANT
Location Address7704 2ND ST NW STE AAlbuquerque, NM 87107-6755
Mailing Address2001 Centro Familiar Blvd SwAlbuquerque, NM 87105-4592 · (505) 873-7400
Phone(505) 873-7400
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateNovember 4, 2010
Last NPPES UpdateMay 16, 20252 updates tracked since enumeration
NPPES CertifiedMay 16, 2025
✔ NPI 1124329339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in NM · PA2011-0057✔ Licensed in CO · 3117
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
7704 2ND ST NW STE A, Albuquerque, NM 87107
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Keith Emory Basham Physician Assistant 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.

PECOS PAC ID3072771963
PECOS Enrollment IDI20120223000413
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lovelace Women's Hospital

Acute Care Hospitals · Albuquerque, NM
1/5 CMS rating
OwnershipProprietary
CMS Certification Number320017
Location4701 Montgomery Boulevard NEAlbuquerque, NM 87109 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87107 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$68.00 typical visit price
range $17.00 – $135.35
Typical copayment $17.00 (range $4.25 – $33.83)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers17 claims17 services$110.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SYLVIA WITTELS M.D.
Family Medicine
7704 2ND ST NW STE A
ALBUQUERQUE, NM 87107
Bernalillo County (505) 890-1458
ALISON LYNN MATTIAS PHYSICIAN ASSISTANT
Physician Assistant
7704 2ND ST NW STE A
ALBUQUERQUE, NM 87107
Bernalillo County (505) 890-1458
MS. LILLY KAYA KYARTHWYN GREEN CNP
Nurse Practitioner (Family)
7704 2ND ST NW STE A
ALBUQUERQUE, NM 87107
Bernalillo County (505) 873-7400

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 Keith Basham's NPI number?

The NPI number for Keith Basham is 1124329339. It was assigned to this individual provider in the NPPES registry on November 4, 2010.

Where is Keith Basham located?

Keith Basham practices at 7704 2nd St NW Ste A, Albuquerque, NM 87107. The listed phone number is (505) 873-7400.

What is Keith Basham's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Keith Basham enrolled in Medicare?

Yes. Keith Basham 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.

Is Keith Basham affiliated with any hospitals?

According to CMS data, Keith Basham is affiliated with Lovelace Women's Hospital.

When was this NPI record last updated?

The NPPES record for Keith Basham was last updated on May 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.