Individual provider Active NPI

Richard M Bunt, M.D.

  • Psychiatry Physician
  • Palm Bay, FL
National Provider Identifier
1376619072
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME046834 Issued in GA
Practice address
4031 Dixie Hwy NE
Palm Bay, FL 32905-3682
Phone
(321) 622-3222
Fax
(321) 622-3203
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME046834 GA Primary

Addresses

Primary practice location

4031 Dixie Hwy NE
Palm Bay, FL 32905-3682

Mailing address

4031 Dixie Hwy NE
Palm Bay, FL 32905-3682
Phone (321) 622-3222

Other identifiers 2

IdentifierTypeStateIssuer
00815746CMedicaidGA
278284700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070817000003 FL Practitioner - Psychiatry 3678465499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
State University of New York Downstate Medical Center, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Behavioral Care LLCGroup PAC ID 1759569106, 5 clinicians

Practice addresses (Care Compare)

4031 Dixie Hwy NE
Palm Bay, FL 32905-3682
Phone (321) 622-3222

911 Columbus Ave
Melbourne, FL 32901-4605
Phone (321) 622-3222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME046834GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Care LLC CurrentSince May 1, 2011 Accepting new patients
Atlanta Psychiatric Speciliasts, P.C. Past Accepting new patients
Atlantic Psychiatric Centers, Inc. Psychiatry PastSince Jan 24, 1997 Accepting new patients

Locations

911 Columbus Ave
Melbourne, FL 32901
Phone (321) 622-3222

4031 Dixie Hwy NE
Palm Bay, FL 32905
Phone (321) 622-3222

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1376619072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4031 DIXIE HWY NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053682",
            "telephone_number": "321-622-3222",
            "fax_number": "321-622-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 DIXIE HWY NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053682",
            "telephone_number": "321-622-3222",
            "fax_number": "321-622-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNT",
        "first_name": "RICHARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "ME046834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00815746C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278284700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

Verify at the official NPI Registry.