Individual provider Active NPI

Adam Patrick Buzzerd, PA C

  • Surgical Physician Assistant
  • Knoxville, TN
National Provider Identifier
1083682579
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1919 Issued in TN
Practice address
10810 Parkside Dr Ste 208
Knoxville, TN 37934-1981
Phone
(865) 647-3350
Fax
(865) 647-3359
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9103471 FL
Surgical Physician Assistant 363AS0400X PA1919 TN Primary

Addresses

Primary practice location

10810 Parkside Dr Ste 208
Knoxville, TN 37934-1981

Mailing address

10810 Parkside Dr Ste 208
Knoxville, TN 37934-1981
Phone (865) 647-3350

Other identifiers 1

IdentifierTypeStateIssuer
Q015212MedicaidTN

Other names 1

  • Adam P Buzzerd Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adam.buzzerd.1@4694.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20151012002413 TN Practitioner - Physician Assistant 6709847676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knoxville Hma Physician Management, LLCGroup PAC ID 6103097316, 118 clinicians

Practice addresses (Care Compare)

10810 Parkside Dr
Knoxville, TN 37934-1981

10810 Parkside Dr
Suite 109
Knoxville, TN 37934-1980
Phone (865) 647-3350

10820 Parkside Dr
Knoxville, TN 37934-1956
Phone (865) 218-7011

7557 A Dannaher Dr
Suite G15
Powell, TN 37849-3558
Phone (865) 859-7377

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1083682579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 PARKSIDE DR STE 208",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341981",
            "telephone_number": "865-647-3350",
            "fax_number": "865-647-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 PARKSIDE DR STE 208",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341981",
            "telephone_number": "865-647-3350",
            "fax_number": "865-647-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZZERD",
        "first_name": "ADAM",
        "middle_name": "PATRICK",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103471",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "PA1919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q015212",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adam.buzzerd.1@4694.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "10810 Parkside Dr Ste 208",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379341981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ADAM",
            "last_name": "BUZZERD",
            "middle_name": "P",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.