Individual provider Active NPI

Amy M Buschur, FNP

  • Nurse Practitioner
  • Centerville, OH
National Provider Identifier
1265866362
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
15015-NP Issued in OH
Practice address
1299 E Alex Bell Rd
Centerville, OH 45459-2658
Phone
(937) 436-1117
Fax
(937) 436-9576
NPI assigned
Aug 26, 2013
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 15015-NP OH Primary

Addresses

Primary practice location

1299 E Alex Bell Rd
Centerville, OH 45459-2658

Mailing address

1299 E Alex Bell Rd
Centerville, OH 45459-2658
Phone (937) 436-1117

Other identifiers 1

IdentifierTypeStateIssuer
0209008MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131016001866 OH Practitioner - Nurse Practitioner 8426282906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of North Central Ohio IncGroup PAC ID 7113058801, 11 clinicians

Practice addresses (Care Compare)

1299 E Alex Bell Rd
Centerville, OH 45459-2658
Phone (937) 436-9576

770 Balgreen Dr
Suite 201
Mansfield, OH 44906-4106
Phone (419) 756-1600

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Promoting interoperability
91
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
15015-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of North Central Ohio Inc CurrentSince Jun 30, 2022 Accepting new patients

Locations

1299 E Alex Bell Rd
Dayton, OH 45459
Phone (937) 436-1117

770 Balgreen Dr
Ste 201
Mansfield, OH 44906
Phone (419) 756-1600

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, 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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1265866362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 E ALEX BELL RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592658",
            "telephone_number": "937-436-1117",
            "fax_number": "937-436-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 E ALEX BELL RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592658",
            "telephone_number": "937-436-1117",
            "fax_number": "937-436-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCHUR",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "15015-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0209008",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

Verify at the official NPI Registry.