Individual provider Active NPI

Robert G. Busse, PT

  • Physical Therapist
  • Oshkosh, WI
National Provider Identifier
1710907993
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3258-024 Issued in WI
Practice address
2100 D. Omro Road
Oshkosh, WI 54904
Phone
(920) 232-4040
Fax
(920) 232-4042
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3258-024 WI Primary

Addresses

Primary practice location

2100 D. Omro Road
Oshkosh, WI 54904

Mailing address

4000 N Providence Ave
Appleton, WI 54913-8018
Phone (920) 257-2009

Other identifiers 2

IdentifierTypeStateIssuer
40267200MedicaidWI
650019367OtherWIRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000067 WI Practitioner - Physical Therapist in Private Practice 8426243999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedic and Spine Therapy of Oshkosh, SCGroup PAC ID 9830118033, 2 clinicians

Practice addresses (Care Compare)

515 S Washburn St
Suite 100
Oshkosh, WI 54904-7951
Phone (920) 232-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3528WIMDPsychologist
3258-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Spine Therapy of Oshkosh SC Physical Therapist CurrentSince Oct 1, 2000 Accepting new patients

Locations

4000 N Providence Ave
Appleton, WI 54913
Phone (920) 257-2000

1000 Midway Rd
Menasha, WI 54952
Phone (920) 257-2000

515 S Washburn St
Ste 100
Oshkosh, WI 54904
Phone (920) 232-4040

2100 Omro Rd
Ste D
Oshkosh, WI 54904
Phone (920) 232-4040

Organizations & group practices 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1710907993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N PROVIDENCE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "telephone_number": "920-257-2009",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 D. OMRO ROAD",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-232-4040",
            "fax_number": "920-232-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSE",
        "first_name": "ROBERT",
        "middle_name": "G.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "3258-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40267200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650019367",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.