Individual provider Active NPI

Stephanie Bujnoski, MS, OTR/L

  • Occupational Therapist
  • Peoria, AZ
National Provider Identifier
1568299451
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-009725 Issued in AZ
Practice address
20783 N 83Rd Ave Ste 103
Peoria, AZ 85382-7430
Phone
(623) 444-8880
Fax
(623) 444-9282
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTH-009725 AZ Primary

Addresses

Primary practice location

20783 N 83Rd Ave Ste 103
Peoria, AZ 85382-7430

Mailing address

20783 N 83Rd Ave Ste 103
Peoria, AZ 85382-7430
Phone (623) 444-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250331001475 AZ Practitioner - Physical Medicine and Rehabilitation 2860915808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brentom LLCGroup PAC ID 8224387816, 2 clinicians

Practice addresses (Care Compare)

20783 N 83Rd Ave
Suite 103
Peoria, AZ 85382-7430
Phone (623) 444-8880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OTH-009725AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brentom, LLC, Occupational Therapist CurrentSince Feb 1, 2025 Accepting new patients

Locations

20783 N 83rd Ave
Ste 103
Peoria, AZ 85382
Phone (623) 444-8880

Organizations & group practices 1

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": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1568299451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20783 N 83RD AVE STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827430",
            "telephone_number": "623-444-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20783 N 83RD AVE STE 103",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827430",
            "telephone_number": "623-444-8880",
            "fax_number": "623-444-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUJNOSKI",
        "first_name": "STEPHANIE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.