Individual provider Active NPI

Steve Timothy Bussa, O.D.

  • Optometrist
  • Plantation, FL
National Provider Identifier
1093965964
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4301 Issued in FL
Practice address
7045 W Broward Blvd
Plantation, FL 33317-2205
Phone
(954) 625-2388
Fax
(954) 625-2390
NPI assigned
Sep 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4301 FL Primary
Optometrist 152W00000X 627 NV

Addresses

Primary practice location

7045 W Broward Blvd
Plantation, FL 33317-2205

Mailing address

7045 W Broward Blvd
Plantation, FL 33317-2205
Phone (954) 625-2388

Other identifiers 1

IdentifierTypeStateIssuer
TYNMD3P3MedicaidFL

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090911000325 FL Practitioner - Optometry 2668527813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Steve T Bussa OD PLLCGroup PAC ID 5193870343, 2 clinicians

Practice addresses (Care Compare)

331 N University Dr
Suite M2 1200
Plantation, FL 33324-1975
Phone (954) 625-2388

3650 Forest Hill Blvd
Suite 2
West Palm Beach, FL 33406-5662
Phone (561) 964-1359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Steve T. Bussa O.D., P.L.L.C. Current Accepting new patients
Dr Steve T. Bussa O.D., P.L.L.C. Optometrist CurrentSince May 7, 2009 Accepting new patients
Alexandra Kehoe, OD PLLC Optometrist CurrentSince Jan 20, 2013 Accepting new patients

Locations

2250 NE 163rd St
North Miami Beach, FL 33160
Phone (305) 354-4786

331 N University Dr
Ste M21200
Plantation, FL 33324
Phone (954) 625-2388

7045 W Broward Blvd
Plantation, FL 33317
Phone (954) 625-2388

3650 Forest Hill Blvd
Ste 2
West Palm Beach, FL 33406
Phone (561) 964-1359

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1093965964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172205",
            "telephone_number": "954-625-2388",
            "fax_number": "954-625-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7045 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172205",
            "telephone_number": "954-625-2388",
            "fax_number": "954-625-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSA",
        "first_name": "STEVE",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-26",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4301",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "627",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TYNMD3P3",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.