Individual provider Active NPI

Michelle Budnick, PA-C

  • Medical Physician Assistant
  • Stuart, FL
National Provider Identifier
1679636583
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004275 Issued in MI
Practice address
969 SE Central Pkwy
Stuart, FL 34994-3904
Phone
(772) 283-0109
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004275 MI Primary

Addresses

Primary practice location

969 SE Central Pkwy
Stuart, FL 34994-3904

Mailing address

969 SE Central Pkwy
Stuart, FL 34994-3904
Phone (772) 283-0109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120508000363 FL Practitioner - Physician Assistant 5092775627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McKay Dermatology and Medspa, PAGroup PAC ID 0143514323, 4 clinicians

Practice addresses (Care Compare)

969 SE Central Pkwy
Stuart, FL 34994-3904
Phone (772) 283-0109

Merit-based Incentive Payment System (MIPS)

Final score
85.89 of 100Reported as group
Quality
75.44
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004275MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SVC Dermatology PC PastSince May 1, 2006 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1679636583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 SE CENTRAL PKWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943904",
            "telephone_number": "772-283-0109",
            "fax_number": "772-283-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 SE CENTRAL PKWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943904",
            "telephone_number": "772-283-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDNICK",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.