Active NPI
Richard Jerome Busek, P.T.
- Physical Therapist
- Yuma, AZ
National Provider Identifier
1609012384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2562
- Practice address
- 3693 W 14TH St
Yuma, AZ 85364-4186 - Phone
- (928) 329-6956
- NPI assigned
- Dec 30, 2008
- Last updated
- Dec 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2562 | AZ | Primary |
Addresses
Primary practice location
3693 W 14TH St
Yuma, AZ 85364-4186
Mailing address
3693 W 14TH St
Yuma, AZ 85364-4186
Phone (928) 329-6956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2562 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230595200000",
"number": "1609012384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3693 W 14TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853644186",
"telephone_number": "928-329-6956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3693 W 14TH ST",
"city": "YUMA",
"state": "AZ",
"postal_code": "853644186",
"telephone_number": "928-329-6956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSEK",
"first_name": "RICHARD",
"middle_name": "JEROME",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-30",
"last_updated": "2008-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "2562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.