Individual provider Active NPI

Karla Elaine Busboom, PA-C

  • Physician Assistant
  • Lawrence, KS
National Provider Identifier
1396981049
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1112 W 6TH St
Ste 124
Lawrence, KS 66044-2215
Phone
(785) 843-9125
Fax
(785) 843-6973
NPI assigned
Dec 31, 2008
Last updated
Jun 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1112 W 6TH St
Ste 124
Lawrence, KS 66044-2215

Mailing address

13616 California St
Ste 100
Omaha, NE 68154-5336
Phone (402) 496-5517

Other identifiers 1

IdentifierTypeStateIssuer
200597400AMedicaidKS

Other names 1

  • Karla Elaine Crose Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20170911002594 NE Practitioner - Physician Assistant 0547327454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nebraska Spine Center, LLPGroup PAC ID 9830080613, 35 clinicians

Practice addresses (Care Compare)

13616 California St
Suite 100
Omaha, NE 68154-5336
Phone (402) 496-5517

4508 38TH St
Suite 210
Columbus, NE 68601-1668
Phone (402) 496-0404

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1396981049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13616 CALIFORNIA ST",
            "address_2": "STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681545336",
            "telephone_number": "402-496-5517",
            "fax_number": "402-496-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 W 6TH ST",
            "address_2": "STE 124",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442215",
            "telephone_number": "785-843-9125",
            "fax_number": "785-843-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSBOOM",
        "first_name": "KARLA",
        "middle_name": "ELAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-31",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200597400A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARLA",
            "last_name": "CROSE",
            "middle_name": "ELAINE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.