NPIMap

Organization Active NPI

Scott L Busch DO PA

  • Otolaryngology/Facial Plastic Surgery Physician
  • Cherry Hill, NJ
National Provider Identifier
1194060889
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
25MB03778600 Issued in NJ
Legal business name
SCOTT L BUSCH DO PA
Practice address
1797 Springdale Rd
Cherry Hill, NJ 08003-2136
Phone
(856) 424-0414
Fax
(856) 424-6335
NPI assigned
Dec 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Alexandra Malamed
Title
Office Manager
Phone
(856) 424-0414

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X
Otolaryngic Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0602X
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0905X 25MB03778600 NJ Primary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 237600000X

Addresses

Primary practice location

1797 Springdale Rd
Cherry Hill, NJ 08003-2136

Mailing address

1797 Springdale Rd
Cherry Hill, NJ 08003-2136
Phone (856) 424-0414

Other practice location 1

777 S White Horse Pike Ste B2
Hammonton, NJ 08037-2029
Phone (609) 561-1234

Other identifiers 1

IdentifierTypeStateIssuer
3392406MedicaidNJ

Other names 1

  • Cherry Hill Center for ENT & Facial Plastic Surgery Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ScottBuschDOPA@123809.advancedmd-direct.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130122000226 NJ Part B Supplier - Clinic/Group Practice 3072766245 Receives reassigned benefits from 4 practitioners
Practice locations: Cherry Hill, NJ; Hammonton, NJ

National Provider Directory

National Provider Directory

Locations

1797 Springdale Rd
Cherry Hill, NJ 08003
Phone (856) 424-0414

Interoperability endpoints

  • Direct secure messaging: scottbuschdopa@123809.advancedmd-direct.com

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1194060889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1797 SPRINGDALE RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032136",
            "telephone_number": "856-424-0414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1797 SPRINGDALE RD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032136",
            "telephone_number": "856-424-0414",
            "fax_number": "856-424-6335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 S White Horse Pike Ste B2",
            "address_purpose": "LOCATION",
            "city": "Hammonton",
            "state": "NJ",
            "postal_code": "080372029",
            "country_code": "US",
            "telephone_number": "609-561-1234",
            "fax_number": "855-863-9361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SCOTT L BUSCH DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "MALAMED",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-424-0414"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NJ",
            "license": "25MB03778600",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3392406",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ScottBuschDOPA@123809.advancedmd-direct.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1797 Springdale Rd",
            "city": "Cherry Hill",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080032136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cherry Hill Center for ENT & Facial Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.