Individual provider Active NPI

Susan Buffington

  • Pediatric Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1003263724
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP 9205104 Issued in FL
Practice address
501 6TH Ave S
Dept of Radiology
St Petersburg, FL 33701-4634
Phone
(727) 767-3318
Fax
(727) 767-8002
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP 9205104 FL Primary

Addresses

Primary practice location

501 6TH Ave S
Dept of Radiology
St Petersburg, FL 33701-4634

Mailing address

501 6TH Ave S
Dept of Radiology
St Petersburg, FL 33701-4634
Phone (727) 767-3318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170324000746 FL Practitioner - Nurse Practitioner 0547545048 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9205104FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Physician Services, Inc. CurrentSince Nov 21, 2016 Accepting new patients

Locations

601 5th St S
Ste 5
St Petersburg, FL 33701
Phone (727) 727-4429

501 6th Ave S
St Petersburg, FL 33701
Phone (727) 344-6060

Interoperability endpoints

  • Direct secure messaging: sbuffington733866@direct.hopkinsmedicine.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1003263724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "address_2": "DEPT OF RADIOLOGY",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-3318",
            "fax_number": "727-767-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "address_2": "DEPT OF RADIOLOGY",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-3318",
            "fax_number": "727-767-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFFINGTON",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP 9205104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.