BASIL D. FOSSUM
NPI 1821043811
Urology in Fort Walton Beach, FL

Q: What is Basil Fossum's NPI number?

The NPI number for Basil Fossum is 1821043811. It was assigned to this individual provider in the NPPES registry on May 24, 2006.

Q: What is Basil Fossum's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Basil Fossum was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since May 24, 2006PECOS EnrolledAccepts Medicare Assignment

0/100

CMS Quality Rating

914B MAR WALT DR, FORT WALTON BEACH, FL 32547(850) 226-6572(850) 862-8564 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 5, 2026, May 22, 2025, Apr 1, 2021 and 2 more (5 updates tracked since 2017).

On this page

About Basil D. Fossum NPPES

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

BASIL D. FOSSUM (NPI 1821043811) is an individual urology provider in Fort Walton Beach, Florida, licensed in Florida (ME53505) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Twin Cities Hospital, and is a graduate of University Of California, San Francisco School Of Medicine (1972).

NPPES Registry Identity

NPI1821043811

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameBASIL D. FOSSUM

Location Address914B MAR WALT DRFort Walton Beach, FL 32547-6706

Mailing Address914 Mar Walt Dr Ste BFort Walton Beach, FL 32547-6706 · (850) 862-2555 · Fax (850) 862-8564

Phone(850) 226-6572

Fax(850) 862-8564

Sole ProprietorYes

Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 1972

Enumeration DateMay 24, 2006

Last NPPES UpdateJanuary 5, 20265 updates tracked since enumeration

NPPES CertifiedJanuary 5, 2026

✔ NPI 1821043811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in FL · ME53505

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Also ListedSpecialistTaxonomy 174400000X · License ME53505 (FL)

914B MAR WALT DR, Fort Walton Beach, FL 32547

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Other Identifiers 6

Other07317FL · Bcbs Fl

Other1193041FL · Wellcare

Other4266997FL · Aetna Thru Emerald Coast Health Alliance

Other593-08600FL · Bcbs Al

OtherP00990540FL · Railroad Medicare

Other159401FL · Universal Healthcare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida.Insurance ›

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

Basil D. Fossum 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 ID7517150055

PECOS Enrollment IDI20101018000299

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.

Areas of Expertise CMS Part B claims 14

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.

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

707 services487 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

461 services349 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

263 services230 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

109 services86 patients

Leuprolide acetate (for depot suspension), 7.5 mg J9217

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

69 services17 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

66 services21 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

56 services11 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

42 services33 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

40 services36 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

38 services38 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

37 services33 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

27 services27 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

23 services14 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

16 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Twin Cities Hospital

Acute Care Hospitals · Niceville, FL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number100054

Location2190 Hwy 85 NNiceville, FL 32578 · Okaloosa County

Emergency services

Hca Florida Fort Walton-Destin Hospital

Acute Care Hospitals · Fort Walton Beach, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100223

Location1000 Mar-Walt DrFort Walton Beach, FL 32547 · Okaloosa County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32547 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

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.

0/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

41%140 patients2/55-star benchmark: 92%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

74%826 patients4/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

95%2,429 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

38%1,110 patients2/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

73%1,631 patients4/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 100% · 519 patients

Patients tobacco: 89% · 519 patients

17%66 patients1/55-star benchmark: 98%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4338

DME-Orthotic Devices · category DF000N

2 suppliers12 claims22 services$10.22 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

3 suppliers23 claims3,240 services$1.72 avg. paid by Medicare

Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each A4352

DME-Orthotic Devices · category DF008N

4 suppliers20 claims4,500 services$5.65 avg. paid by Medicare

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357

DME-Orthotic Devices · category DF000N

5 suppliers18 claims82 services$8.02 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.

BASIL FOSSUM MD PA

Urology

914B MAR WALT DR
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 862-2555

21ST CENTURY ONCOLOGY LLC

Urology

914B MAR WALT DR
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 226-6572

JOHN R BURNS MD

Urology

914B MAR WALT DR
FORT WALTON BEACH, FL 32547

Okaloosa County (850) 226-6572

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 Basil Fossum's NPI number?

The NPI number for Basil Fossum is 1821043811. It was assigned to this individual provider in the NPPES registry on May 24, 2006.

Where is Basil Fossum located?

Basil Fossum practices at 914B Mar Walt Dr, Fort Walton Beach, FL 32547. The listed phone number is (850) 226-6572.

What is Basil Fossum's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Basil Fossum enrolled in Medicare?

Yes. Basil Fossum 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.

What insurance does Basil Fossum accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida list Basil Fossum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Basil Fossum affiliated with any hospitals?

According to CMS data, Basil Fossum is affiliated with Hca Florida Twin Cities Hospital and Hca Florida Fort Walton-Destin Hospital.

When was this NPI record last updated?

The NPPES record for Basil Fossum was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.