Individual provider Active NPI

Mark K Buyyounouski, M.D.

  • Radiation Oncology Physician
  • Stanford, CA
National Provider Identifier
1912927021
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
C55796 Issued in CA
Practice address
300 Pasteur Dr
Stanford, CA 94305-2200
Phone
(650) 723-4000
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD4211507 PA
Radiation Oncology Physician 2085R0001X MD421507 PA
Radiation Oncology Physician 2085R0001X C55796 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Mailing address

1804 Embarcadero Rd
Suite 100
Palo Alto, CA 94303-3341
Phone (650) 723-4000

Other identifiers 1

IdentifierTypeStateIssuer
1013293250001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130624000417 CA Practitioner - Radiation Oncology 4688602055 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Rutgers New Jersey Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD4211507PAMDSpecialist
C55796CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Health Care CurrentSince Jul 1, 2013 Accepting new patients
University Healthcare Alliance CurrentSince Jul 15, 2020 Accepting new patients
LPCH Medical Group Div of Lucile CurrentSince Jul 15, 2020 Accepting new patients
Stanford Health Care CurrentSince Jul 1, 2013 Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients
American Oncologic Hospital Past Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Affinity Medical Group Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Health Services of Fox Chase Cancer Center Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

875 Blake Wilbur Dr
Palo Alto, CA 94304
Phone (650) 723-7621

5725 W Las Positas Blvd
Ste 100B
Pleasanton, CA 94588
Phone (925) 621-7700

5725 W Las Positas Blvd
Ste 100
Pleasanton, CA 94588

4725 1st St
Ste 100
Pleasanton, CA 94566
Phone (925) 462-7060

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • Direct secure messaging: mbuyyounouski80807@direct.stanfordhealthcare.org

Organizations & group practices 10

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.

Hospital & facility affiliations 8

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1912927021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 EMBARCADERO RD",
            "address_2": "SUITE 100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943033341",
            "telephone_number": "650-723-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUYYOUNOUSKI",
        "first_name": "MARK",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD4211507",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "PA",
            "license": "MD421507",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "C55796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013293250001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.