Individual provider Active NPI

Bricker B Buseth, O.D.

  • Optometrist
  • Jackson, MI
National Provider Identifier
1356329338
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003336 Issued in MI
Practice address
2500 Reynolds Rd
Jackson, MI 49201-9376
Phone
(517) 262-0318
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3336 MI
Optometrist 152W00000X 4901003336 MI Primary

Addresses

Primary practice location

2500 Reynolds Rd
Jackson, MI 49201-9376

Mailing address

2500 Reynolds Rd
Jackson, MI 49201-9376
Phone (517) 262-0318

Other identifiers 1

IdentifierTypeStateIssuer
900C876200OtherMIBCBS OF MI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110718000682 MI Practitioner - Optometry 8527174614 Reassigns benefits to 1 organization
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3336MIMDOptometrist
4901003336MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bricker B Buseth Optometrist CurrentSince May 26, 2020 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Mar 16, 2020 Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Michigan, LLC Optometrist CurrentSince Mar 16, 2020 Accepting new patients
Mid Michigan Eye Care Center, PC Optometrist PastSince Apr 1, 1994 Accepting new patients

Locations

800 S Brown St
Jackson, MI 49203
Phone (517) 787-8890

Interoperability endpoints

  • Direct secure messaging: bbuseth554933@direct.hfhs.org

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1356329338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 REYNOLDS RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019376",
            "telephone_number": "517-262-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 REYNOLDS RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019376",
            "telephone_number": "517-262-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSETH",
        "first_name": "BRICKER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "3336",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "900C876200",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.