Kimberly Rene Buffalo, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Grove, OK
NPI 1356829352 · NPPES record last updated May 16, 2023
Key facts
- NPI
- 1356829352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 212781 (OK)
- Practice address
- 2104 S Main St
Grove, OK 74344-5356 - Phone
- (918) 964-7071
- Fax
- (800) 872-8213
- NPI assigned
- Aug 1, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2104 S Main St
B 7
Grove, OK 74344-5356
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- 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 |
|---|---|---|---|---|
| I20230905003040 | OK | Practitioner - Nurse Practitioner | 7810072212 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0080324 | OK | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Musuma Health Care and Medical Spa, PLLC | Current |
Accepting new patients |
Locations
2104 S Main St
Ste B7
Grove, OK 74344
Phone (918) 964-7071
2104 S Main St
Ste B
Grove, OK 74344
2104 S Main St
Grove, OK 74344
Phone (918) 964-7071
2104 S Main St
#B7
Grove, OK 74344
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R0080324 | OK | |
| Family Nurse Practitioner | 363LF0000X | 212781 | OK | Yes |
Addresses
Primary practice location
2104 S Main St
Grove, OK 74344-5356
Mailing address
2104 S Main St
Grove, OK 74344-5356
Phone (918) 964-7071
Other providers in Grove, OK
- Shelbi Ann Brock
- Hannah Brown
- Lauren Margaret Brown
- Bryan Downing, D.D.S.
- Kathryn Buchanan
- Robert Franklyn Burke
- Renee Burks
- Teresa Kay Butler
- Paul Edward Callicoat Jr.
- Paula Calvin
All providers in Grove, OK · Family Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2023. 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.