Active NPI
Russell S Bufalino, M.D.,J.D.
- Orthotist
- Old Forge, PA
National Provider Identifier
1609836907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- MD008940E
- Practice address
- 313 S Main St
Old Forge, PA 18518-1606 - Phone
- (570) 451-1122
- Fax
- (570) 451-0541
- NPI assigned
- Mar 23, 2006
- Last updated
- Mar 18, 2010
- 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 |
|---|---|---|---|---|
| Orthotist | 222Z00000X | MD008940E | PA | Primary |
Addresses
Primary practice location
313 S Main St
Old Forge, PA 18518-1606
Mailing address
313 S Main St
Old Forge, PA 18518-1606
Phone (570) 451-1122
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 817264 | Other | PA | 1ST PRIORITY |
| 7289228 | Other | PA | AETNA |
| BU108435 | Other | PA | BLUE CROSS BLUE SHIELD |
| 1563559 | Medicaid | PA |
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)
- Enrolled
- Credentials
- Juris Doctor, Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268870400000",
"number": "1609836907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 S MAIN ST",
"city": "OLD FORGE",
"state": "PA",
"postal_code": "185181606",
"telephone_number": "570-451-1122",
"fax_number": "570-451-0541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 S MAIN ST",
"city": "OLD FORGE",
"state": "PA",
"postal_code": "185181606",
"telephone_number": "570-451-1122",
"fax_number": "570-451-0541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUFALINO",
"first_name": "RUSSELL",
"middle_name": "S",
"credential": "M.D.,J.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2010-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "PA",
"license": "MD008940E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1ST PRIORITY",
"identifier": "817264",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7289228",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "BU108435",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1563559",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Old Forge, PA
- Albert S Bilski Jr.
- Michael Patrick Bilski, DPT
- Stephen Brosky, RPH
- Nicole Brush, NCC,LPC
- Stephen Brush
- Lindsay Marie Bukowski, CRNP
- Timothy Burns, PHARM.D.
- Capitano Pharmaceutical Services Inc (Capitano's Pharmacy)
- Capitano's Pharmacy (Capitanos Pharmaceutial Services, INC.)
- Sharon Brady Chase, M.C.,CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.