Individual provider Active NPI

Rukia N Busaidy, AGACNP-BC

  • Nurse Practitioner
  • Kennewick, WA
National Provider Identifier
1598433609
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2021037103 Issued in TX
Practice address
3810 Plaza Way
Kennewick, WA 99338-2722
Phone
(509) 221-7000
NPI assigned
Sep 2, 2021
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2021037103 TX Primary

Addresses

Primary practice location

3810 Plaza Way
Kennewick, WA 99338-2722

Mailing address

3810 Plaza Way
Kennewick, WA 99338-2722
Phone (509) 221-7000

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
I20220811003301 WA Practitioner - Nurse Practitioner 7214335553 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington Pac Services PCGroup PAC ID 4082986070, 43 clinicians
RCCH Trios Health LLCGroup PAC ID 5799035416, 65 clinicians

Practice addresses (Care Compare)

2004 N 22ND Ave
Pasco, WA 99301-3313
Phone (509) 547-8811

216 W 10TH Ave
Kennewick, WA 99336-6304

3810 Plaza Way
Kennewick, WA 99338-2722
Phone (509) 221-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2021037103TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wa Pacs 2 PC CurrentSince Jan 1, 2023 Accepting new patients
Washington Pac Services PC CurrentSince Jan 1, 2023 Accepting new patients
CS Pacs 3 Northwest, LLC CurrentSince Sep 28, 2024 Accepting new patients
RCCH Trios Health LLC CurrentSince May 1, 2022 Accepting new patients

Locations

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

21008 76th Ave W
Edmonds, WA 98026
Phone (425) 778-0107

135 S 336th St
Federal Way, WA 98003
Phone (253) 835-7433

216 W 10th Ave
Ste 204
Kennewick, WA 99336
Phone (509) 221-5520

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

2004 N 22nd Ave
Pasco, WA 99301
Phone (208) 995-1122

920 12th Ave SE
Puyallup, WA 98372
Phone (253) 841-3422

3600 E Hartson Ave
Spokane, WA 99202
Phone (509) 468-7000

14820 E 4th Ave
Spokane Valley, WA 99216
Phone (509) 922-1644

414 S University Rd
Spokane Valley, WA 99206
Phone (509) 924-4650

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1598433609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 PLAZA WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382722",
            "telephone_number": "509-221-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 PLAZA WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382722",
            "telephone_number": "509-221-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSAIDY",
        "first_name": "RUKIA",
        "middle_name": "N",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "2021037103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.