Individual provider Active NPI

Susan Katherine Buyaki, LMSW

  • Clinical Social Worker
  • Jackson, MI
National Provider Identifier
1205483591
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801096142 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4730
NPI assigned
Aug 21, 2019
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801096142 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190919000794 MI Practitioner - Clinical Social Worker 6002146925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

205 N E Ave
Henry Ford Allegiance Behavioral Health Out
Jackson, MI 49201-1753
Phone (517) 205-4730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Social Worker CurrentSince Sep 11, 2019 Accepting new patients
W. a. Foote Memorial Hospital, Inc. Social Worker Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Sep 11, 2019 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

744 W Michigan Ave
Ste 200
Jackson, MI 49201
Phone (517) 205-3120

Interoperability endpoints

  • Direct secure messaging: sbuyaki607605@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1205483591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUYAKI",
        "first_name": "SUSAN",
        "middle_name": "KATHERINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.