Individual provider Active NPI

Kacey Rice Busque, NNP

  • Neonatal Nurse Practitioner
  • Madison, WI
National Provider Identifier
1508408089
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
14684-33 Issued in WI
Practice address
700 S Park St
Madison, WI 53715-1830
Phone
(931) 993-5073
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 187805 TN
Neonatal Nurse Practitioner 363LN0000X 4704380497 MI
Neonatal Nurse Practitioner 363LN0000X 14684-33 WI Primary

Addresses

Primary practice location

700 S Park St
Madison, WI 53715-1830

Mailing address

11228 N Mason Dr
Edgerton, WI 53534-8554
Phone (931) 993-5073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240110003616 WI Practitioner - Nurse Practitioner 6901257328 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
187805TNMDNeonatal Intensive Care Registered Nurse
4704380497MIMDNeonatal Nurse Practitioner
14684-33WIMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Jan 1, 2024 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jan 1, 2024 Accepting new patients
Pediatrix Medical Group of Michigan PC Past Accepting new patients

Locations

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Interoperability endpoints

  • Direct secure messaging: kbusque498216@direct-ehr-ssmhc.com

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": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1508408089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11228 N MASON DR",
            "city": "EDGERTON",
            "state": "WI",
            "postal_code": "535348554",
            "telephone_number": "931-993-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "931-993-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSQUE",
        "first_name": "KACEY",
        "middle_name": "RICE",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "TN",
            "license": "187805",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MI",
            "license": "4704380497",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WI",
            "license": "14684-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.