KEITH EMORY BASHAM (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1124329339
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
896 PHYSICIAN ASSISTANT in NM
Provider Addresses for KEITH EMORY BASHAM (PHYSICIAN ASSISTANT)
2001 CENTRO FAMILIAR BLVD SW
ALBUQUERQUE, NM 871054592
Phone: (505) 873-7400
Type: Mailing
7704 2ND ST NW STE A
ALBUQUERQUE, NM 871076755
Phone: (505) 873-7400
Type: Location
1607 VAN CLEAVE RD NW
ALBUQUERQUE, NM 871073441
Phone: (505) 463-1730
Type: Mailing
1 UNIVERSITY OF NEW MEXICO
DEPT. OF EMERGENCY MEDICINE, MSC 6025
ALBUQUERQUE, NM 871310001
Phone: (505) 272-5062
Fax: (505) 272-6503
Type: Location
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 $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-02-09 • Largest payer in this snapshot: Lilly USA, LLC ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $18 |
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: 2012-02-23
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 |
|---|---|---|---|---|
| I20120223000413 | I | Physician Assistant | NM | 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 | 78 | 58 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 29 | 25 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 87105)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | NM | 83036 | Hemoglobin A1C level | 15 | 14 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NM | |
| Internal Medicine | NM | |
| Nurse Practitioner | NM | |
| Nurse Practitioner | NM | |
| Physician Assistant | CO | |
| - | NM | |
| Nurse Practitioner | NM | |
| Nurse Practitioner | NM | |
| Family Practice | NM | |
| Nurse Practitioner | CA |
Reviews
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