Individual provider Active NPI

John Christen Bunyasaranand, DO

  • Emergency Medicine Physician
  • Eglin AFB, FL
National Provider Identifier
1780105817
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS18810 Issued in FL
Practice address
4315 El Salvador Way
Eglin AFB, FL 32542-1711
Phone
(850) 885-9979
NPI assigned
Jun 28, 2017
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X DO.2634 AL
Emergency Medicine Physician 207P00000X OS18810 FL Primary
Military Health Care Provider 171000000X 2634 AL

Addresses

Primary practice location

4315 El Salvador Way
Eglin AFB, FL 32542-1711

Mailing address

4315 El Salvador Way
Eglin AFB, FL 32542-1711
Phone (850) 885-2371

Other practice location 1

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-2474

Other identifiers 1

IdentifierTypeStateIssuer
VAD000OtherMEDICARE UPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211129002228 AL Practitioner - Emergency Medicine 5193074201 Reassigns benefits to 1 organization
I20220502002306 FL Practitioner - Emergency Medicine 5193074201 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Campbell Univ School of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-7762

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
93.19
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
49.22 of 100Reported as group
Quality
8.06
Improvement activities
40
Cost
90.69

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2634ALMDMilitary Health Care Provider
DO.2634ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Emergency Group, LLC Emergency Medicine CurrentSince Oct 22, 2021 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Pensacola Emergency Physicians, LLC Emergency Medicine CurrentSince Feb 25, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Mar 13, 2024 Accepting new patients
Pensacola Emergency Physicians, LLC Emergency Medicine CurrentSince Feb 25, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Mar 13, 2024 Accepting new patients
Santa Rosa HB Medical Services LLC Emergency Medicine CurrentSince Jul 21, 2023 Accepting new patients

Locations

849 S Three Notch St
Andalusia, AL 36420
Phone (334) 222-6907

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

4250 Woodbine Rd
Pace, FL 32571
Phone (850) 626-7761

123 Baptist Way
Pensacola, FL 32503
Phone (850) 434-4011

1501 W Nine Mile Rd
Pensacola, FL 32534
Phone (850) 416-4940

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

Hospital & facility affiliations 3

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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1780105817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 EL SALVADOR WAY",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421711",
            "telephone_number": "850-885-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 EL SALVADOR WAY",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421711",
            "telephone_number": "850-885-9979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_purpose": "LOCATION",
            "city": "Tripler Army Medical Center",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-2474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNYASARANAND",
        "first_name": "JOHN",
        "middle_name": "CHRISTEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.2634",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS18810",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "AL",
            "license": "2634",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN",
            "identifier": "VAD000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin AFB, FL

Sources for this page

Verify at the official NPI Registry.