Individual provider Active NPI

Tori Bussanmas, MD

  • Pediatrics Physician
  • Burnsville, MN
National Provider Identifier
1255034799
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
82599 Issued in MN
Practice address
501 E Nicollet Blvd Ste 200
Burnsville, MN 55337-6785
Phone
(952) 278-7000
NPI assigned
Mar 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 82599 MN Primary

Addresses

Primary practice location

501 E Nicollet Blvd Ste 200
Burnsville, MN 55337-6785

Mailing address

6600 France Ave S Ste 315
Edina, MN 55435-1803

Other practice location 1

6600 France Ave S Ste 315
Edina, MN 55435-1803
Phone (952) 278-7000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230628000701 MO Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9830557586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
94-11398KSMDPediatrics Physician
2023019648MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southdale Pediatric Associates, LTD Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/1846cf9e-8006-4277-b72f-3cbbe8a8f5ca/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1255034799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 315",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E NICOLLET BLVD STE 200",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376785",
            "telephone_number": "952-278-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 France Ave S Ste 315",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554351803",
            "country_code": "US",
            "telephone_number": "952-278-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSSANMAS",
        "first_name": "TORI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "82599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.