NPIMap

Individual provider Active NPI

Joseph Edward Busam, PA-C

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1659896744
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005167RX Issued in OH
Practice address
405 W Grand Ave
Dayton, OH 45405-7538
Phone
(937) 723-3200
NPI assigned
Aug 9, 2017
Last updated
Nov 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-10707 NC
Physician Assistant 363A00000X 50.005167RX OH Primary

Addresses

Primary practice location

405 W Grand Ave
Dayton, OH 45405-7538

Mailing address

297 Curragh CV
Fuquay Varina, NC 27526-8798
Phone (513) 600-6562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210210003190 NC Practitioner - Physician Assistant 8729351580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-10707NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Em-I Medical Services, Professional Association Physician Assistant Past Accepting new patients
Emergency Coverage Services, PC Physician Assistant Past Accepting new patients
Bobcat Emergency Physicians LLC Physician Assistant Past Accepting new patients
Erie Banks Emergency Physicians LLC Physician Assistant Past Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1659896744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 CURRAGH CV",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275268798",
            "telephone_number": "513-600-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W GRAND AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454057538",
            "telephone_number": "937-723-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSAM",
        "first_name": "JOSEPH",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10707",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005167RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.