MEDICARE: JAMES RICHARD BUSKIRK PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA10292	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	ZZZ79046Z	OTHER	CA	FQHC MEDICARE PART B
4	05-1822	OTHER	CA	FQHC MEDICARE PART A

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HAP11991F	OTHER	CA	FPACT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659474963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES RICHARD BUSKIRK PA

Provider Business Mailing Address
First Line	:	1601 FRUITVALE AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94601-2322
Country	:	US
Telephone Number	:	510-535-4000
Fax Number	:	510-535-4128

Provider Business Practice Location Address
First Line	:	1030 INTERNATIONAL BLVD
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94601
Country	:	US
Telephone Number	:	510-238-5400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	02/15/2026

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