Individual provider Active NPI

Elizabeth Messina Bussone, NNP-BC

  • Neonatal Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1073771465
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP3197 Issued in AZ
Practice address
7720 N 16TH St
Ste 425
Phoenix, AZ 85020-4492
Phone
(602) 476-8962
Fax
(623) 643-9236
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN065239 AZ
Neonatal Nurse Practitioner 363LN0000X AP3197 AZ Primary

Addresses

Primary practice location

7720 N 16TH St
Ste 425
Phoenix, AZ 85020-4492

Mailing address

7720 N 16TH St
Ste 425
Phoenix, AZ 85020-4492
Phone (602) 476-8962

Other identifiers 1

IdentifierTypeStateIssuer
383196MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150707000832 TX Practitioner - Nurse Practitioner 0446494322 Reassigns benefits to 1 organization
I20151201001841 AZ Practitioner - Nurse Practitioner 0446494322 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN065239AZMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince May 22, 2015 Accepting new patients
Maricopa County Special Health Care District CurrentSince Dec 1, 2015 Accepting new patients
Maricopa County Special Health Care District CurrentSince Dec 1, 2015 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince May 22, 2015 Accepting new patients
Maricopa County Special Health Care District Past Accepting new patients
Arizona OB GYN Affiliates PC Past Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

2601 E Roosevelt St
Fl 2
Phoenix, AZ 85008

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

Interoperability endpoints

  • Direct secure messaging: ebussone112380@direct.valleywisehealth.org

Organizations & group practices 6

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1073771465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 N 16TH ST",
            "address_2": "STE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204492",
            "telephone_number": "602-476-8962",
            "fax_number": "623-643-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 N 16TH ST",
            "address_2": "STE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204492",
            "telephone_number": "602-476-8962",
            "fax_number": "623-643-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSONE",
        "first_name": "ELIZABETH",
        "middle_name": "MESSINA",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN065239",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AZ",
            "license": "AP3197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383196",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.