Individual provider Active NPI

Christopher Busapavanij, PA-C

  • Medical Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1952589814
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
012317 Issued in NY
Practice address
152 Broadway
Brooklyn, NY 11211-8767
Phone
(212) 385-3700
Fax
(212) 385-3703
NPI assigned
Feb 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 012317 NY Primary

Addresses

Primary practice location

152 Broadway
Brooklyn, NY 11211-8767

Mailing address

152 Broadway
Brooklyn, NY 11211-8767
Phone (212) 385-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080310000352 NY Practitioner - Physician Assistant 1658456041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bobby Buka, M.D., P.C.Group PAC ID 0547351140, 140 clinicians

Practice addresses (Care Compare)

152 Broadway
Brooklyn, NY 11211-8767
Phone (212) 385-3700

220 Front St
New York, NY 10038-2033
Phone (212) 385-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012317NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bobby Buka, M.D., P.C. CurrentSince Feb 18, 2019 Accepting new patients
Out East Medical PastSince Jun 15, 2021 Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Atlas Infectious Disease Practice PLLC Past Accepting new patients
Derm Specs of PA PLLC PastSince Feb 25, 2024 Accepting new patients

Locations

3179 Steinway St
Astoria, NY 11103

1163 Myrtle Ave
Brooklyn, NY 11206

440 Atlantic Ave
Fl Ground
Brooklyn, NY 11217
Phone (718) 797-5504

4411 8th Ave
Brooklyn, NY 11220
Phone (718) 283-8225

1027 46th Ave
Fl 1
Long Island City, NY 11101

625 10th Ave
New York, NY 10036

1425 2nd Ave
New York, NY 10021

1425 2nd Ave
#74
New York, NY 10021

2121 Adam Clayton Powell Jr Blvd
New York, NY 10027
Phone (718) 534-8190

214 Sullivan St
New York, NY 10012

3531 Long Beach Rd
Oceanside, NY 11572

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22363/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCDAA

Organizations & group practices 5

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": "1201996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1952589814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112118767",
            "telephone_number": "212-385-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112118767",
            "telephone_number": "212-385-3700",
            "fax_number": "212-385-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSAPAVANIJ",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-03",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.