Todd G Bussian, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

46-7729 Issued in IL

Practice address

980 W South St
Freeport, IL 61032-6777

Phone

(815) 235-3466

Fax

(815) 235-1712

NPI assigned

Aug 19, 2006

Last updated

Feb 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: todd.bussian@direct.revolutionehr.com

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1639283138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 W SOUTH ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326777",
            "telephone_number": "815-235-3466",
            "fax_number": "815-235-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W SOUTH ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326777",
            "telephone_number": "815-235-3466",
            "fax_number": "815-235-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSIAN",
        "first_name": "TODD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46-7729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46-7729",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Burnell, L.C.S.W.
• Susan Burrow, QIDP
• Tina Buske
• Marjorie Buss
• Stephania Buss
• C & C Foundations LTD
• Princess Nicole Victoria Cabuhat, OTR/L
• Camelot Endodontics LTD (Camelot Endodontics)
• Camelot Radiology Associates LTD (Northern Illinois Radiologists)
• Patricia A Canier

• Optometrist in Freeport, IL
• Providers in Freeport, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.