Individual provider Active NPI

Brian A Bucina, D.O.

  • Surgery Physician
  • Winslow, AZ
National Provider Identifier
1902010549
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101016779 Issued in MI
Practice address
200 Lee St
Winslow, AZ 86047-2603
Phone
(928) 289-3396
Fax
(928) 289-2801
NPI assigned
May 10, 2007
Last updated
Jul 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101016779 MI Primary

Addresses

Primary practice location

200 Lee St
Winslow, AZ 86047-2603

Mailing address

200 Lee St
Winslow, AZ 86047-2603
Phone (928) 289-3396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130524000604 AZ Practitioner - General Surgery 3779751789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Arizona College of Osteopathic Medicine Mid Western University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winslow Memorial Hospital IncGroup PAC ID 8628988409, 44 clinicians

Practice addresses (Care Compare)

1501 N Williamson Ave
Winslow, AZ 86047-2735

200 Lee St
Winslow, AZ 86047-2603
Phone (928) 289-3396

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Memorial Hospital Inc CurrentSince May 1, 2013 Accepting new patients

Locations

1500 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-3396

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

200 Lee St
Winslow, AZ 86047
Phone (928) 226-6400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1902010549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LEE ST",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472603",
            "telephone_number": "928-289-3396",
            "fax_number": "928-289-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LEE ST",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860472603",
            "telephone_number": "928-289-3396",
            "fax_number": "928-289-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCINA",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101016779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winslow, AZ

Sources for this page

Verify at the official NPI Registry.