Individual provider Active NPI

Erna Busch-Devereaux, M.D,

  • Surgery Physician
  • Huntington, NY
National Provider Identifier
1669550620
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
180237 Issued in NY
Practice address
152 E Main St
Suite a
Huntington, NY 11743-2958
Phone
(631) 423-1414
Fax
(631) 423-4902
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 180237 NY Primary

Addresses

Primary practice location

152 E Main St
Suite a
Huntington, NY 11743-2958

Mailing address

270 Pulaski Rd
Suite a
Greenlawn, NY 11740-1605
Phone (631) 423-1414

Other identifiers 1

IdentifierTypeStateIssuer
2827H1OtherNYBCBS PROV ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041007000748 NY Practitioner - General Surgery 5799751194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PC 6,374 clinicians

Practice addresses (Care Compare)

270 Pulaski Rd
Greenlawn, NY 11740-1605
Phone (631) 351-5757

Hospital & facility affiliations

  • Peconic Bay Homehealth Services Home health agency, Riverhead, NY, CCN 337400
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
  • NS/Lij HS Huntington Hospital Hospital, Huntington, NY, CCN 330045
  • Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy30
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
180237NYMDSurgery Physician

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Nov 26, 2012 Accepting new patients
Prohealth Care Associates, LLP Past Accepting new patients

Locations

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

270 Pulaski Rd
Greenlawn, NY 11740
Phone (631) 376-0055

270 Pulaski Rd
Ste A
Greenlawn, NY 11740
Phone (631) 423-1414

152 E Main St
Ste A
Huntington, NY 11743
Phone (631) 385-7258

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: ernabuschdevereaux@nslijmedgr.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1669550620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 PULASKI RD",
            "address_2": "SUITE A",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401605",
            "telephone_number": "631-423-1414",
            "fax_number": "631-423-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 E MAIN ST",
            "address_2": "SUITE A",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432958",
            "telephone_number": "631-423-1414",
            "fax_number": "631-423-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH-DEVEREAUX",
        "first_name": "ERNA",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "180237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV ID",
            "identifier": "2827H1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.