Tracey L Busby, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M7014 Issued in ID

Practice address

100 Hospital Drive
Suite 105
Ketchum, ID 83340-0000

Phone

(208) 622-8811

Fax

(208) 622-6921

NPI assigned

May 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Family Practice

Education

Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbusby17088@direct.slhs.org

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.

• St Lukes Clinic - Wood River LLC

  • Internal Medicine Physician
  • Ketchum, ID
  • NPI 1972891604

  Family Medicine

  Medicare reassignment Care Compare group NPD
• St Lukes Wood River Medical Center LTD

  • Medicare Defined Swing Bed Hospital Unit
  • Ketchum, ID
  • NPI 1275662546
  NPD (past)

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

• St Lukes Wood River Medical Center LTD

  • Critical Access Hospital
  • Ketchum, ID
  • NPI 1508869470
  Care Compare affiliation

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375142400000",
    "number": "1124072251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DRIVE",
            "address_2": "SUITE 105",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833400000",
            "telephone_number": "208-622-8811",
            "fax_number": "208-622-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSBY",
        "first_name": "TRACEY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2013-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M7014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003576900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P00659676",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gene D Branum, MD
• Teresa Brennan, R.D.
• Ashley Brown, PA-C
• Katherine Mary Buckley, MD
• Anthony Maisin Buoncristiani, M.D.
• John Franklin Calvert, D.D.S.
• Ralph P Campanale II, M.D.
• Julie Ann Carney, LCSW
• Sasha Sherylle Chavez, NP-C
• Sydney Chickrell, RN

• Family Medicine Physician in Ketchum, ID
• Providers in Ketchum, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.