Provider Demographics
NPI:1902998594
Name:BUSS, MATTHEW S
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:S
Last Name:BUSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 KESSLER ST
Mailing Address - Street 2:STE 300
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204
Mailing Address - Country:US
Mailing Address - Phone:913-632-2900
Mailing Address - Fax:913-632-2999
Practice Address - Street 1:7450 KESSLER ST
Practice Address - Street 2:STE 300
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-632-2900
Practice Address - Fax:913-632-2999
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27536207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS25004040OtherBLUE CROSS
G69146Medicare UPIN
KSS148337Medicare ID - Type Unspecified