BASIL O JR. IKE – Sports Medicine (Family Medicine) Physician, NPI 1114553146
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,237 FAMILY PRACTICE in CA
Provider Addresses for BASIL O JR. IKE
11234 ANDERSON ST
LOMA LINDA, CA 923542804
Phone: (909) 558-6688
Type: Mailing
101 THE CITY DR S
ORANGE, CA 928683201
Phone: (999) 999-9999
Type: Location
200 S MANCHESTER AVE STE 835
ORANGE, CA 928683213
Phone:
Fax: (800) 465-3203
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $56.
Total Amount is formed as General ($56) + Research ($0) + Ownership ($0) = $56.
Last reported payment date: 2024-07-26 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($56).
Total Amount
$56
General + Research + Ownership
Payments
1
Total payment records
General Amount
$56
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| DePuy Synthes Sales Inc. | $56 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-09-17
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240917004404 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92354)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CA | |
| Family Practice | CA | |
| Family Practice, Sports Medicine | CA | |
| - | CA | |
| Family Practice | WA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | CA | |
| General Surgery | NV | |
| Family Practice | CA | |
| Family Practice | CA | |
| Family Practice | CA |
Reviews
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