BASIL D. FOSSUM – Urology Physician, NPI 1821043811
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
898 UROLOGY in FL
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Provider Addresses for BASIL D. FOSSUM
914 MAR WALT DR STE B
FORT WALTON BEACH, FL 325476706
Phone: (850) 862-2555
Fax: (850) 862-8564
Type: Mailing
Mar Walt Drive, Wright, Fort Walton Beach, Okaloosa County, Florida, 32547, United States
FORT WALTON BEACH, FL 325476706
Phone: (850) 226-6572
Fax: (850) 862-8564
Type: Location
2234, Colonial Boulevard, Fort Myers, Lee County, Florida, 33907, United States
ATTN: PAYER CONTRACTING & RELATIONS
FORT MYERS, FL 339071412
Phone: (239) 931-7342
Fax: (239) 931-7385
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $226.
Total Amount is formed as General ($226) + Research ($0) + Ownership ($0) = $226.
Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($91).
Total Amount
$226
General + Research + Ownership
Payments
13
Total payment records
General Amount
$226
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Sumitomo Pharma America, Inc. | $91 |
| Janssen Biotech, Inc. | $66 |
| ABBVIE INC. | $34 |
| HOLLISTER INCORPORATED | $17 |
| ABC Home Medical Supply, Inc. | $17 |
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: 2010-10-18
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20101018000299 | I | Urology | FL | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 400 | 282 | $0 |
| 81001 | Manual urinalysis test with examination using microscope, automated | 388 | 308 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 383 | 342 | $0 |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 115 | 19 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 111 | 68 | $0 |
Insurance plans in this area (ZIP 32547)
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Provider's Procedures
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