STAR BUMBANAC NPI 1205212289

NPI Information

  • NPI: 1205212289
  • Provider Name: STAR BUMBANAC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1001 WEST ST
    CARTHAGE, NY
    ZIP 13619
  • Phone: (734) 793-6140

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NPI Details

Star Bumbanac is a family nurse practitioner in Carthage, NY with 11 years of experience. Star Bumbanac NPI is 1205212289. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduation Year:2015

The provider's business location address is:

1001 WEST ST
CARTHAGE, NY
ZIP 13619-703
Phone: (734) 793-6140
Fax: (734) 402-0254

The NPI 1205212289 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Automated urinalysis test (HCPCS:81003)

The enumeration date for this NPI number is 8/3/2015 and was last updated on 5/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner339827NEW YORKNo
2363L00000XNurse Practitioner209027342ILLINOISNo
3363L00000XNurse Practitioner71014684AINDIANANo
4363L00000XNurse Practitioner4704380462MICHIGANNo
5363L00000XNurse PractitionerAPRN.CNP.0030868OHIONo
6363L00000XNurse Practitioner14414INDIANANo
7363L00000XNurse PractitionerSP029531PENNSYLVANIANo
8363LF0000XNurse PractitionerFamily11014087FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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