Autumn Bussuvanno, is a medicare enrolled "Psychologist" provider in Minneapolis, Minnesota. Her current practice location is
701 Park Ave, Minneapolis, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(612) 873-3000.
Autumn Bussuvanno is licensed to practice in Minnesota (license number LP6858) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013525021.
Healthcare Provider's Profile
| Full Name | Autumn Bussuvanno |
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| Gender | Female |
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| Speciality | Psychologist |
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| Location | 701 Park Ave, Minneapolis, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1013525021
- Provider Enumeration Date: 07/15/2020
- Last Update Date: 03/28/2024
Medicare PECOS Information:
- PECOS PAC ID: 9133596414
- Enrollment ID: I20221028001342
Medical Identifiers
Medical identifiers for Autumn Bussuvanno such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013525021 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | LP6858 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Autumn Bussuvanno allows following entities to bill medicare on her behalf.
| Entity Name | Hennepin Healthcare System Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033138136
PECOS PAC ID: 4789684861
Enrollment ID: O20070207000467 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Autumn Bussuvanno is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Autumn Bussuvanno,
701 Park Ave,
Minneapolis, MN 55415-1623
Ph: (612) 873-3000 | Autumn Bussuvanno,
701 Park Ave,
Minneapolis, MN 55415-1623
Ph: (612) 873-3000 |
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