Kathleen Davis Bukowsky, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1740 Issued in SC

Practice address

2880 Tricom St
North Charleston, SC 29406-9171

Phone

(843) 797-5050

Fax

(843) 797-3633

NPI assigned

Jan 11, 2012

Last updated

Mar 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kathleen Lyne Davis Former name

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arcis Healthcare LLCGroup PAC ID 0042448748, 34 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.55 of 100Reported as individual

Quality

59.19

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.bukowsky.1@7388.direct.athenahealth.com

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.

• Arcis Healthcare, LLC

  • Orthopaedic Surgery Physician
  • North Charleston, SC
  • NPI 1902246077

  Medical

  Medicare reassignment Care Compare group NPD
• Arcis Healthcare, LLC

  dba Lowcountry Orthopaedics & Sports Medicine

  • Durable Medical Equipment & Medical Supplies
  • Ladson, SC
  • NPI 1881406767
  NPD

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1689944373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-5050",
            "fax_number": "843-797-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKOWSKY",
        "first_name": "KATHLEEN",
        "middle_name": "DAVIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1740",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARCIS HEALTHCARE GROUP MEDICARE PTAN #",
            "identifier": "D043",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARCIS HEALTHCARE GROUP MEDICAID ID #",
            "identifier": "GP6337",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DAVIS",
            "middle_name": "LYNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Martha Buchanan, MD
• Michael Joseph Buchanan, TECHNICIAN
• Emily Louise Buchholz, DPT
• April Garris Buckingham, PA-C
• Remi Danielle Buckingham, MOT, OTR
• Steven F Bull, MD
• Rachel Dawn Bullington, PHARMD
• Carol Bulwinkle, LPC
• Elizabeth Heinz Bumgarner, NURSE
• Campbell Victoria Bun

• Medical Physician Assistant in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.