Individual provider Active NPI

Heidi Byers Busch, M.D.

  • Dermatology Physician
  • Vista, CA
National Provider Identifier
1467415174
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
C51650 Issued in CA
Practice address
906 Sycamore Ave Ste 100
Vista, CA 92081-7851
Phone
(760) 249-7007
Fax
(858) 550-0676
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X C51650 CA Primary

Addresses

Primary practice location

906 Sycamore Ave Ste 100
Vista, CA 92081-7851

Mailing address

906 Sycamore Ave Ste 100
Vista, CA 92081-7851
Phone (760) 249-7007

Other identifiers 1

IdentifierTypeStateIssuer
00C516500MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040917000520 CA Practitioner - Dermatology 5395713473 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C51650CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
J Robert West, M.D., Inc Dermatology CurrentSince Aug 1, 2022 Accepting new patients
Comprehensive Dermatology Group Dermatology CurrentSince Jan 18, 2014 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Scripps Clinic Medical Group, Inc Past Accepting new patients

Locations

6010 Hidden Valley Rd
Ste 120
Carlsbad, CA 92011
Phone (760) 448-4484

477 N El Camino Real
Ste C204
Encinitas, CA 92024
Phone (760) 230-2256

781 Garden View Ct
Ste 201
Encinitas, CA 92024
Phone (760) 634-3316

477 N El Camino Real
Ste D308
Encinitas, CA 92024
Phone (760) 436-2300

400 Newport Center Dr
Ste 702
Newport Beach, CA 92660
Phone (949) 644-0101

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1467415174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 SYCAMORE AVE STE 100",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817851",
            "telephone_number": "760-249-7007",
            "fax_number": "858-550-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 SYCAMORE AVE STE 100",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817851",
            "telephone_number": "760-249-7007",
            "fax_number": "858-550-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "HEIDI",
        "middle_name": "BYERS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C51650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C516500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.