Individual provider Active NPI

Collin Bufano

  • Emergency Medicine Physician
  • Gainesville, FL
National Provider Identifier
1043744774
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A17848 Issued in CA
Practice address
1147 NW 64TH Ter
Gainesville, FL 32605-4218
Phone
(352) 333-4000
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X A17848 CA Primary

Addresses

Primary practice location

1147 NW 64TH Ter
Gainesville, FL 32605-4218

Mailing address

PO Box 147006
Gainesville, FL 32614-7006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200717001371 CA Practitioner - Emergency Medicine 3678997053 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Touro Un Col of Osteopathic Medicine, New York, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Practice addresses (Care Compare)

215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone (805) 497-2727

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.74
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.41 of 100Reported as group
Quality
79.31
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A17848CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Los Robles Emergency Physicians Medical Group Emergency Medicine CurrentSince Oct 1, 2023 Accepting new patients
Valley Presbyterian Emergency Medical Associates Emergency Medicine CurrentSince Aug 3, 2021 Accepting new patients
Sherman Oaks Emergency Medical Associates Emergency Medicine CurrentSince Dec 15, 2021 Accepting new patients
Berkeley Emergency Medical Group, Inc. Emergency Medicine PastSince Jan 22, 2023 Accepting new patients

Locations

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

4929 Van Nuys Blvd
Van Nuys, CA 91403
Phone (818) 907-4561

15107 Vanowen St
Van Nuys, CA 91405
Phone (818) 782-6600

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1043744774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147006",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326147006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-333-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFANO",
        "first_name": "COLLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A17848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.