Timothy G Bussert, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Jackson, WY
NPI 1306333687 · NPPES record last updated Jan 28, 2025
Key facts
- NPI
- 1306333687
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 315831 (NY)
- Practice address
- 555 E Broadway Ave Ste 108
Jackson, WY 83001-8640 - Phone
- (307) 734-1005
- NPI assigned
- Apr 22, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Teton County Hospital District
Practice addresses (Care Compare)
625 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-3636
Hospital & facility affiliations
- St Johns Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.06 of 100
- Quality
- 96.61
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 31.11
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220808002076 | NY | Practitioner - Obstetrics/Gynecology | 7416339486 | Reassigns benefits to 1 organization |
| I20250514001066 | WY | Practitioner - Obstetrics/Gynecology | 7416339486 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University OB/GYN Associates | Obstetrics & Gynecology | Current |
Accepting new patients |
| Teton County Hospital District | Current |
Accepting new patients | |
| Teton County Hospital District | Past | Accepting new patients |
Locations
725 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 464-5162
750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 315831 | NY | Yes |
Addresses
Primary practice location
555 E Broadway Ave Ste 108
Jackson, WY 83001-8640
Mailing address
555 E Broadway Ave Ste 108
Jackson, WY 83001-8640
Phone (307) 734-1005
Other providers in Jackson, WY
- Andrew Brandon Bullington
- Misti Dawn Burke
- Ryan Burke
- Glenn Edward Burnett II
- Cossette Burnham
- Dennis L Butcher
- Marian Jones Butcher
- Cristina Calcai
- Sarah Wilcox Caldwell
- Edward Callaghan
All providers in Jackson, WY · Obstetrics & Gynecology Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2025. 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.