Kelly Christine Busche, PA-C
Individual provider Active NPI Physician Assistant · Hollidaysburg, PA
NPI 1306331558 · NPPES record last updated Jun 28, 2018
Key facts
- NPI
- 1306331558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- OA004496 (PA)
- Practice address
- 800 S Logan Blvd Ste 1200
Hollidaysburg, PA 16648-3051 - Phone
- (814) 946-7568
- Fax
- (814) 943-7490
- NPI assigned
- Jun 28, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Broad Top Area Medical Center Inc
Practice addresses (Care Compare)
6678 Towne Ctr Blvd
Huntingdon, PA 16652-6934
Phone (814) 643-1232
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260108003533 | PA | Practitioner - Physician Assistant | 2668958620 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA059833 | PA | MD | Physician Assistant |
| OA004496 | PA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broad Top Area Medical Center Inc | Current |
Accepting new patients | |
| Broad Top Area Medical Center, Inc | Current |
Accepting new patients | |
| Broad Top Area Medical Center Inc | Past | Accepting new patients |
Locations
375 S Kishacoquillas St
Belleville, PA 17004
Phone (717) 935-2065
4133 Medical Center Dr
Broad Top, PA 16621
Phone (814) 506-8463
6674 Towne Center Blvd
Huntingdon, PA 16652
Phone (814) 643-1232
814 Washington St
Huntingdon, PA 16652
Phone (814) 623-4415
6678 Towne Center Blvd
Huntingdon, PA 16652
Phone (814) 506-8490
790 Bryan St
Huntingdon, PA 16652
Phone (814) 643-8299
835 Washington St
Huntingdon, PA 16652
Phone (814) 506-8114
6311 Margy Dr
Huntingdon, PA 16652
Phone (814) 506-8490
Interoperability endpoints
- k.busche@broadtopmedical.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA059833 | PA | |
| Physician Assistant | 363A00000X | OA004496 | PA | Yes |
Addresses
Primary practice location
800 S Logan Blvd Ste 1200
Hollidaysburg, PA 16648-3051
Mailing address
5635 E Pleasant Valley Blvd
Tyrone, PA 16686-8569
Phone (814) 330-5851
Other providers in Hollidaysburg, PA
- Gretta G Brown
- Janelle Brumbaugh
- Renee Brunner
- Nicole Marie Bukosky
- David W Bundy Jr.
- Wendy Michelle Bush
- Kirsten Butterbaugh
- Shannon Cameron
- Alycia Renee Campbell
- Christine Marie Capone
All providers in Hollidaysburg, PA · Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.