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Active NPI 1174110043 Individual Practitioner Male Practitioner

Phillip Buganski , LAT, OTC

Technician, Other • Vadnais Heights, MN

Professional Overview & Biography Verified Profile Summary

Phillip Buganski, LAT, OTC is a registered healthcare professional specializing in Technician, Other in Vadnais Heights, MN. Practice services are available at 3580 ARCADE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3580 Arcade St

Vadnais Heights, MN 551277135

Telephone 6519685200
Fax 6517303750
Associated Practice Facility / Clinic
🏢 Summit Orthopedics, Ltd Facility NPI 1215358346

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician, Other in Vadnais Heights, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Vadnais Heights, MN (254 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-12-28
Technician, Other Primary Specialty

NUCC Taxonomy Code: 247200000X

State License MN 2389

A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID License
2389 (MN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

24 Associated Practitioners
Kelsey Stevens

Physician Assistant

NPI 1033713821
Casey Kelly , CNP

Nurse Practitioner

NPI 1174018246

Certified Nurse Practitioner

Nicholas Bjore , PA-C

Physician Assistant - Surgical

NPI 1235420670

Physician Assistant (Certified)

Ramana Gutierrez , OTR

Occupational Therapist

NPI 1295254183

Occupational Therapist Registered

Becky Burdick , PA-C

Physician Assistant

NPI 1366461840

Physician Assistant (Certified)

Ronda Ellevold , ATC

Specialist/Technologist - Athletic Trainer

NPI 1376812040

Certified Athletic Trainer

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active December 28, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location December 28, 2020

Registered at 3580 ARCADE ST, VADNAIS HEIGHTS, MN 551277135 (Tel: 6519685200)

📍
Updated Business Mailing Address December 28, 2020

Registered at 4952 EMMIT DR N UNIT 2, HUGO, MN 550388505 (Tel: 7633552874)

👤
Provider Name / Credentials Updated December 28, 2020

Recorded as PHILLIP BUGANSKI, LAT, OTC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 28, 2020

Technician, Other (License #2389 in MN)

🟢
Initial NPI Registration & Enumeration December 28, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1174110043
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 28, 2020
Last Update: December 28, 2020
Sole Proprietor: Yes

Mailing Address

4952 Emmit Dr N Unit 2

Hugo, MN 550388505

Phone: 7633552874

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.