Active NPI
Jacques Emile Bussiere, CSA
- Surgical Assistant
- Waldorf, MD
National Provider Identifier
1366917627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- Practice address
- 2453 Kenbrook CT
Waldorf, MD 20603-3227 - Phone
- (301) 257-6191
- NPI assigned
- Oct 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | Primary |
Addresses
Primary practice location
2453 Kenbrook CT
Waldorf, MD 20603-3227
Mailing address
PO Box 221135
Chantilly, VA 20153-1135
Phone (703) 349-1379
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4887 | Other | DC | NSAA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Precision Surgical Assist, LLC | Surgical Assistant | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgical Physician Assistant
- Richmond, VA
- NPI 1659254969
Surgical Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778803200000",
"number": "1366917627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 221135",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201531135",
"telephone_number": "703-349-1379",
"fax_number": "703-591-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2453 KENBROOK CT",
"city": "WALDORF",
"state": "MD",
"postal_code": "206033227",
"telephone_number": "301-257-6191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSSIERE",
"first_name": "JACQUES EMILE",
"name_prefix": "Mr.",
"credential": "CSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-12",
"last_updated": "2026-05-15",
"certification_date": "2026-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NSAA",
"identifier": "4887",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.