Individual provider Active NPI

Jill Bujnevicie, PA

  • Physician Assistant
  • Burien, WA
National Provider Identifier
1487679502
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60043087 Issued in WA
Practice address
16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone
(206) 431-5314
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0003078 MD
Physician Assistant 363A00000X PA60043087 WA Primary

Addresses

Primary practice location

16251 Sylvester Rd SW
Burien, WA 98166-3017

Mailing address

PO Box 94391
Ms/LB 310054
Seattle, WA 98124-6691
Phone (800) 579-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20090211000781 WA Practitioner - Physician Assistant 6002858024 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1295MAMDMarriage & Family Therapist
C0003078MDMDMedical Physician Assistant

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1487679502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94391",
            "address_2": "MS/LB 310054",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246691",
            "telephone_number": "800-579-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16251 SYLVESTER RD SW",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663017",
            "telephone_number": "206-431-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUJNEVICIE",
        "first_name": "JILL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0003078",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60043087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.