Active NPI
Bradley Busacco, M.D.
- Obstetrics & Gynecology Physician
- Cincinnati, OH
National Provider Identifier
1205839503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 35048242B
- Practice address
- 7495 State Rd
Ste 325
Cincinnati, OH 45255-6404 - Phone
- (513) 233-2000
- Fax
- (513) 624-2684
- NPI assigned
- May 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 35048242B | OH | Primary |
Addresses
Primary practice location
7495 State Rd
Ste 325
Cincinnati, OH 45255-6404
Mailing address
2060 Reading Rd
Suite 150
Cincinnati, OH 45202-1454
Phone (513) 721-3200
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 287923 | Other | OH | AMERIGROUP |
| 0511655 | Medicaid | OH | |
| 0720620 | Other | OH | UNITED HEALTHCARE |
| 1023323 | Other | OH | AETNA |
| 31157505103 | Other | OH | CARESOURCE |
| 000000020974 | Other | OH | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35048242B | OH | MD | Obstetrics & Gynecology Physician |
Interoperability endpoints
- bbusacco@shwhc.gwaydirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438128000000",
"number": "1205839503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2060 READING RD",
"address_2": "SUITE 150",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452021454",
"telephone_number": "513-721-3200",
"fax_number": "513-639-3186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7495 STATE RD",
"address_2": "STE 325",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452556404",
"telephone_number": "513-233-2000",
"fax_number": "513-624-2684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSACCO",
"first_name": "BRADLEY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2015-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OH",
"license": "35048242B",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "287923",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0511655",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0720620",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "1023323",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "31157505103",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000020974",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.