Paul Faybusovich, D.O

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

OT019251 Issued in PA

Practice address

1900 Centracare Cir Ste 1325
Saint Cloud, MN 56303-5000

Phone

(320) 654-3650

Fax

(320) 654-3681

NPI assigned

Apr 18, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Internal MedicineAlso: Allergy/Immunology

Education

New York College of Osteo Medicine of New York Institute of Technology, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
• Meeker Memorial Hospital Hospital, Litchfield, MN, CCN 241366

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pfaybusovich615146@direct.centracare.com

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.

• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Cloud, MN
  • NPI 1043212665
  Medicare reassignment Care Compare group NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD
• Centracare Clinic

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD

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

• County of Meeker

  • Rural Health Clinic/Center
  • Litchfield, MN
  • NPI 1083221816

  Hospital

  Care Compare affiliation
• County of Meeker

  • Critical Access Hospital
  • Litchfield, MN
  • NPI 1598860215
  Care Compare affiliation
• County of Meeker

  • Rural Health Clinic/Center
  • Dassel, MN
  • NPI 1952555146

  Hospital

  Care Compare affiliation
• St Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1811150618
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Care Compare affiliation
• St. Cloud Hospital

  • Mental Health Counselor
  • Sartell, MN
  • NPI 1083161814

  Hospital

  Care Compare affiliation
• St. Cloud Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Saint Cloud, MN
  • NPI 1467615294
  Care Compare affiliation
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1841502929
  Care Compare affiliation
• St. Cloud Hospital

  • Psychiatric Hospital Unit
  • Saint Cloud, MN
  • NPI 1932419058
  Care Compare affiliation

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1497109219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 1325",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3650",
            "fax_number": "320-654-3681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 1325",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3650",
            "fax_number": "320-654-3681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYBUSOVICH",
        "first_name": "PAUL",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-18",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "OT019251",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS020058",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Michael Farmer, MS., M.ED., LPCC
• Katrina Leigh Fasen, NP
• Kathryn Faulkner, PSY.D.
• Agnes Leonella Faundeen, FNP-C
• Julianne Elizabeth Fauske, MD
• Tara Leigh Featherston, RN
• Gwen N Feddema
• Melanie Ann Feddema, OTR/L
• Ralph E Fedor, M.D.
• Terri Fedorenko

• Allergy & Immunology Physician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Allergy & Immunology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.