Individual provider Active NPI

Mark Buraczynski, PA-C

  • Physician Assistant
  • Santa Cruz, CA
National Provider Identifier
1336277441
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13445 Issued in CA
Practice address
2900 Chanticleer Ave
Santa Cruz, CA 95065-1816
Phone
(831) 477-2200
NPI assigned
Mar 1, 2007
Last updated
Jan 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA13445 CA Primary

Addresses

Primary practice location

2900 Chanticleer Ave
Santa Cruz, CA 95065-1816

Mailing address

2025 Soquel Ave
Santa Cruz, CA 95062-1323
Phone (831) 479-6603

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081129000019 CA Practitioner - Physician Assistant 5799845343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA13445CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Cruz Emergency Physicians Medical Group Current Accepting new patients
Cep America-California CurrentSince Jan 1, 2012 Accepting new patients
Cep America - California CurrentSince Jan 1, 2012 Accepting new patients
Watsonville Emergency Medical Group Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1555 Soquel Dr
Santa Cruz, CA 95065
Phone (831) 462-7700

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

75 Nielson St
#D
Watsonville, CA 95076
Phone (831) 761-5613

Organizations & group practices 5

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1336277441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323",
            "telephone_number": "831-479-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CHANTICLEER AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651816",
            "telephone_number": "831-477-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURACZYNSKI",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.