Active NPI
Ronald W Busuttil, MD
- Transplant Surgery Physician
- Los Angeles, CA
National Provider Identifier
1639103906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Transplant Surgery Physician
- License
- G22460
- Practice address
- 200 UCLA Medical PLZ Ste 214
Los Angeles, CA 90095-8344 - Phone
- (310) 794-7788
- Fax
- (310) 794-3344
- NPI assigned
- Jul 10, 2006
- Last updated
- Dec 30, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Transplant Surgery Physician | 204F00000X | G22460 | CA | Primary |
Addresses
Primary practice location
200 UCLA Medical PLZ Ste 214
Los Angeles, CA 90095-8344
Mailing address
5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Other practice location 1
200 Medical Plaza Suite 530
Los Angeles, CA 90095-0001
Phone (310) 825-5318
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G224600 | Medicaid | CA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22460 | CA | MD | Pediatric Dentist |
| G22460 | CA | MD | Transplant Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Regents of the University of California | Past | Accepting new patients |
Interoperability endpoints
- rbusuttil59428@direct.uclahealth.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba UCLA Pediatric Surgery Associates
- Pediatric Surgery Physician
- Los Angeles, CA
- NPI 1851357941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1639103906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900455631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UCLA MEDICAL PLZ STE 214",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958344",
"telephone_number": "310-794-7788",
"fax_number": "310-794-3344"
}
],
"practiceLocations": [
{
"address_1": "200 Medical Plaza Suite 530",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900950001",
"country_code": "US",
"telephone_number": "310-825-5318",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUSUTTIL",
"first_name": "RONALD",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "204F00000X",
"taxonomy_group": "",
"desc": "Transplant Surgery",
"state": "CA",
"license": "G22460",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G224600",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.