Michael Charles Buben

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP00001152 Issued in WA

Practice address

826 Alder St
South Bend, WA 98586-4900

Phone

(360) 875-5579

Fax

(360) 875-5235

NPI assigned

Jun 16, 2006

Last updated

Mar 23, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Dr. Michael Charles Buben Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Pacific County Hospital District 2

  dba Willapa Harbor Hospital

  • Critical Access Hospital
  • South Bend, WA
  • NPI 1295708683
  NPD (past)
• Pacific County Hospital District 2

  dba Willapa Medical Clinic

  • Rural Health Clinic/Center
  • South Bend, WA
  • NPI 1760582522

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1417991530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985860269",
            "telephone_number": "360-875-5579",
            "fax_number": "360-875-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 ALDER ST",
            "city": "SOUTH BEND",
            "state": "WA",
            "postal_code": "985864900",
            "telephone_number": "360-875-5579",
            "fax_number": "360-875-5235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBEN",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001152",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "OP00001152",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR&INDUSTRY-BUBEN",
            "identifier": "0049602",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11143410",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7093644",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7125362",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035732",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "BUBEN",
            "middle_name": "CHARLES",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rachel Anne Adamyk, PTA
• Barbara Ann Alford, ARNP, FNP-BC, NP-C
• Lori Craig Ashley, RN
• Karime Nazareth Bolivar
• County of Pacific (Pacific County Public Health and Human Service Department)
• David A Cox, RPH
• Matthew J Cox, RPH
• Sherry A Franks, PA-C
• Denise Garoutte-Bell, RD

• Family Medicine Physician in South Bend, WA
• Providers in South Bend, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.