Individual provider Active NPI

Matthew Busalacchi, PHARMD

  • Pharmacist
  • Brookfield, WI
National Provider Identifier
1851008494
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21223 Issued in WI
Practice address
18665 Emerald Cir Unit a
Brookfield, WI 53045-3699
Phone
(414) 339-3780
NPI assigned
Nov 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21223 WI Primary

Addresses

Primary practice location

18665 Emerald Cir Unit a
Brookfield, WI 53045-3699

Mailing address

18665 Emerald Cir Unit a
Brookfield, WI 53045-3699
Phone (414) 339-3780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1851008494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18665 EMERALD CIR UNIT A",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530453699",
            "telephone_number": "414-339-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18665 EMERALD CIR UNIT A",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530453699",
            "telephone_number": "414-339-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSALACCHI",
        "first_name": "MATTHEW",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "21223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.