Individual provider Active NPI

Anne B. Bussard, LCSW-R

  • Clinical Social Worker
  • Horseheads, NY
National Provider Identifier
1003805334
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R 053342-1 Issued in NY
Practice address
17 Groff Rd
Horseheads, NY 14845-7925
Phone
(607) 738-0733
Fax
(607) 562-8854
NPI assigned
Oct 19, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R 053342-1 NY Primary

Addresses

Primary practice location

17 Groff Rd
Horseheads, NY 14845-7925

Mailing address

17 Groff Rd
Horseheads, NY 14845-7925
Phone (607) 738-0733

Other identifiers 1

IdentifierTypeStateIssuer
01751775MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407000333 NY Practitioner - Clinical Social Worker 8426041229 Reassigns benefits to 1 organization
Practice locations: Horseheads, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Schuyler County Mental HealthGroup PAC ID 8527970177, 4 clinicians

Practice addresses (Care Compare)

106 S Perry St
Suite 4
Watkins Glen, NY 14891-1636
Phone (607) 535-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R 053342-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler County Mental Health Clinical CurrentSince Jan 24, 2008 Accepting new patients
Schuyler County CurrentSince Jan 24, 2008 Accepting new patients
Chemung Medical Services PC Past Accepting new patients
Fort Edward Rescue Squad Inc Past Accepting new patients

Locations

106 S Perry St
Watkins Glen, NY 14891
Phone (607) 535-8140

106 S Perry St
Ste 4
Watkins Glen, NY 14891
Phone (607) 535-8282

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003805334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 GROFF RD",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148457925",
            "telephone_number": "607-738-0733",
            "fax_number": "607-562-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 GROFF RD",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148457925",
            "telephone_number": "607-738-0733",
            "fax_number": "607-562-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSARD",
        "first_name": "ANNE",
        "middle_name": "B.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R 053342-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01751775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Horseheads, NY

Sources for this page

Verify at the official NPI Registry.