Individual provider Active NPI

Lili Anna Buzsaki, M.D.

  • General Practice Physician
  • Plant City, FL
National Provider Identifier
1255710083
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME137103 Issued in FL
Practice address
2011 N Wheeler St # 410
Plant City, FL 33563-1860
Phone
(201) 957-5681
NPI assigned
May 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X ME137103 FL
Public Health & General Preventive Medicine Physician 2083P0901X 1255710083 KY
General Practice Physician 208D00000X ME137103 FL Primary

Addresses

Primary practice location

2011 N Wheeler St # 410
Plant City, FL 33563-1860

Mailing address

910 Pinellas Bayway S Apt 205
Tierra Verde, FL 33715-2125
Phone (201) 957-5681

Other practice location 1

1225 W 190th St Ste 280
Gardena, CA 90248-4305
Phone (310) 515-8113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201111003067 FL Practitioner - PsychiatryPractitioner - General PracticePractitioner - Preventive Medicine 7113280447 Reassigns benefits to 1 organization
I20230517001686 CA Practitioner - Psychiatry 7113280447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ehab Yacoub MD IncGroup PAC ID 5092099523, 179 clinicians

Practice addresses (Care Compare)

1225 W 190TH St
Suite 280
Gardena, CA 90248-4305
Phone (877) 515-8113

130 S Indian River Dr
Suite 202
Fort Pierce, FL 34950-4353
Phone (310) 515-8113

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1255710083KYMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ehab Yacoub MD Inc. CurrentSince May 15, 2023 Accepting new patients
Florida Clinical Practice Association Inc Past Accepting new patients
White Sands Treatment Center of Tampa, LLC Past Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

3200 E Guasti Rd
Ste 100
Ontario, CA 91761
Phone (877) 414-7739

11801 Pierce St
Ste 200
Riverside, CA 92505
Phone (323) 547-2662

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

14541 Delano St
Van Nuys, CA 91411
Phone (310) 515-8113

130 S Indian River Dr
Ste 202
Fort Pierce, FL 34950
Phone (310) 515-8113

Interoperability endpoints

  • Direct secure messaging: lili.buzsaki@217526021193732.direct.elationemr.com

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": "1432598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1255710083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 PINELLAS BAYWAY S APT 205",
            "city": "TIERRA VERDE",
            "state": "FL",
            "postal_code": "337152125",
            "telephone_number": "201-957-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 N WHEELER ST # 410",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335631860",
            "telephone_number": "201-957-5681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 W 190th St Ste 280",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902484305",
            "country_code": "US",
            "telephone_number": "310-515-8113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUZSAKI",
        "first_name": "LILI",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-26",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME137103",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "KY",
            "license": "1255710083",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME137103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

Verify at the official NPI Registry.