BASEM MOHAMED ELBROLOSY (M.D.) – Family Medicine Physician, NPI 1326211582
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
886 FAMILY PRACTICE in ME
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Provider Addresses for BASEM MOHAMED ELBROLOSY (M.D.)
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT
PO BOX 7291
LEWISTON, ME 042407291
Phone: (207) 777-8950
Fax: (207) 777-8800
Type: Mailing
1230, Maine Street, South Poland, Poland, Androscoggin County, Maine, 04274, United States
POLAND, ME 042747325
Phone: (207) 998-4483
Fax: (207) 998-2189
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $110.
Total Amount is formed as General ($110) + Research ($0) + Ownership ($0) = $110.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Exact Sciences Corporation ($30).
Total Amount
$110
General + Research + Ownership
Payments
5
Total payment records
General Amount
$110
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2024-08-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20201006000891 | I | Family Practice | ME | TBD |
| I20240828000918 | I | Family Practice | VA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 133 | 68 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 41 | 41 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 22 | 20 | $0 |
Insurance plans in this area (ZIP 04240)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | VA | |
| Physician Assistant | VA | |
| E N D O C R I N O L O G Y | GA | |
| - | VA | |
| Internal Medicine | VA | |
| Family Practice | VA | |
| - | OH | |
| - | VA | |
| U R O L O G Y | IL | |
| - | VA |
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