Individual provider Active NPI

Daniel A Buzard, NP

  • Gerontology Nurse Practitioner
  • West Roxbury, MA
National Provider Identifier
1376525576
Registry record updated Dec 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
193025 Issued in MA
Practice address
211 Mount Vernon St
West Roxbury, MA 02132-2825
Phone
(617) 816-5451
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 193025 MA Primary

Addresses

Primary practice location

211 Mount Vernon St
West Roxbury, MA 02132-2825

Mailing address

211 Mount Vernon St
West Roxbury, MA 02132-2825
Phone (617) 816-5451

Other identifiers 1

IdentifierTypeStateIssuer
1200992MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040505001059 MA Practitioner - Nurse Practitioner 2264420462 Reassigns benefits to 2 organizations
Practice locations: Lexington, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Jan 30, 2012 Accepting new patients
Steward Medical Group, Inc CurrentSince Jan 30, 2012 Accepting new patients
Medical Care of Boston Management Corporation CurrentSince Jan 2, 2013 Accepting new patients
Hallmark Health System Inc Gerontology Past Accepting new patients

Locations

11 Nevins St
Brighton, MA 02135
Phone (617) 562-2782

11 Nevins St
Ste 401
Brighton, MA 02135
Phone (617) 682-7788

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

246 Walnut St
Ste 104
Newtonville, MA 02460
Phone 6172443322104

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Interoperability endpoints

  • Direct secure messaging: dbuzard460074@direct.bilh.masshiway.net

Organizations & group practices 4

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260662400000",
    "number": "1376525576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MOUNT VERNON ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021322825",
            "telephone_number": "617-816-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MOUNT VERNON ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021322825",
            "telephone_number": "617-816-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUZARD",
        "first_name": "DANIEL",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2009-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "193025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200992",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

Verify at the official NPI Registry.