David J Buzanoski, MD
Individual provider Active NPI Pediatrics Physician · Portland, ME
NPI 1194011668 · NPPES record last updated May 4, 2015
Key facts
- NPI
- 1194011668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD20608 (ME)
- Practice address
- 22 Bramhall St
Portland, ME 04102-3134 - Phone
- (207) 662-7060
- Fax
- (207) 662-7066
- NPI assigned
- Jun 23, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Michigan State University College of Human Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mymichigan Medical Center Midland
Practice addresses (Care Compare)
4401 N Campus RDG Dr
Midland, MI 48640-6112
Phone (989) 837-9200
4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250
Hospital & facility affiliations
- Mymichigan Medical Center Midland
- Mymichigan Medical Center Clare
- Mymichigan Medical Center Gladwin
- Mymichigan Medical Center Alma
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in UT, MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160628002051 | UT | Practitioner - Internal Medicine | 7618101320 | Reassigns benefits to 1 organization |
| I20170821002454 | MI | Practitioner - Pediatric Medicine |
7618101320 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Utah Regional Hospitalists LLC | Current |
Accepting new patients | |
| Mymichigan Medical Center Midland | Current |
Accepting new patients | |
| Mymichigan Medical Center Midland | Current |
Accepting new patients | |
| Utah Regional Hospitalists LLC | Current |
Accepting new patients |
Locations
4401 N Campus Ridge Dr
Ste 2100
Midland, MI 48640
Phone (989) 837-9300
4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250
4401 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9280
4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956
1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111
3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111
Interoperability endpoints
- dbuzanoski64606@mymichiganhealth.midirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD20608 | ME | |
| Pediatrics Physician | 208000000X | MD20608 | ME | Yes |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3134
Mailing address
301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600
Other providers in Portland, ME
- Matthew Samuel Buttarazzi
- Blue B Butterfield
- Arielle D. Butterly
- Kara Marie Button
- Mary-Ann Butts
- Jared L Buzzell
- Michael L Buzzell
- BVP Residential Care, LLC
- Amos Byamungu
- Gorette Byishimo
All providers in Portland, ME · Pediatrics Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.