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DR. SUSAN BUDNICK M.D.
NPI 1396165569
Internal Medicine in Boston, MA

Active since April 25, 2014PECOS EnrolledAccepts Medicare Assignment
79.48/100
CMS Quality Rating
801 MASSACHUSETTS AVE, CROSSTOWN 2, BOSTON, MA 44106(617) 414-7399(617) 414-4676 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 28, 2024, May 24, 2017 (2 updates tracked since 2017).

About Dr. Susan Budnick M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSAN BUDNICK M.D. (NPI 1396165569) is an individual internal medicine provider in Boston, Massachusetts, licensed in Massachusetts (1020351) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, is affiliated with Boston Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1396165569
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. SUSAN BUDNICKCredential: M.D.
Location Address801 MASSACHUSETTS AVE, CROSSTOWN 2Boston, MA 44106-1702
Mailing Address960 Massachusetts Ave, Fl2 Provider EnrollmentBoston, MA 02118
Phone(617) 414-7399
Fax(617) 414-4676
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateApril 25, 2014
Last NPPES UpdateJune 28, 20242 updates tracked since enumeration
NPPES CertifiedJune 21, 2024
✔ NPI 1396165569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in MA · 1020351✔ Licensed in OH · 35.131221
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
801 MASSACHUSETTS AVE, Boston, MA 44106
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, WellSense Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Susan Budnick M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153741624
PECOS Enrollment IDI20240706000463
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Susan Budnick reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Evans Medical Foundation, Inc.
0.2 mi
Internal Medicine
1 BOSTON MEDICAL CTR PL
Boston, MA 02118
  • Reassigned Medicare billing, Massachusetts enrollment
  • 573 clinicians in this Medicare group
NPI 1912954124 (617) 358-3510
Inpatient Medical Services, Inc.
541 mi
Internal Medicine
5700 DARROW RD STE 106
Hudson, OH 44236
  • Reassigned Medicare billing, Ohio enrollment
  • 215 clinicians in this Medicare group
NPI 1093756314 (844) 474-4019
University Hospitals Medical Group Inc
546 mi
Multi-Specialty
11100 EUCLID AVE
Cleveland, OH 44106
  • Reassigned Medicare billing, Ohio enrollment
  • 3,958 clinicians in this Medicare group
NPI 1669499414 (216) 844-1000
4M Hospitalist Services, LLC
546 mi
Internal Medicine
525 E MARKET ST
Akron, OH 44304
  • Reassigned Medicare billing, Ohio enrollment
  • 259 clinicians in this Medicare group
NPI 1508288531 (844) 474-4019

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
124 services49 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
44 services42 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
25 services19 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
24 services24 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
20 services20 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Boston Medical Center

Acute Care Hospitals · Boston, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220031
Location1 Boston Medical Center PlaceBoston, MA 02118 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.51
Promoting Interoperability100
Improvement Activities40
Cost63.09

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier13 claims13 services$68.17 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Budnick's NPI number?

The NPI number for Susan Budnick is 1396165569. It was assigned to this individual provider in the NPPES registry on April 25, 2014.

Where is Susan Budnick located?

Susan Budnick practices at 801 Massachusetts Ave Crosstown 2, Boston, MA 44106. The listed phone number is (617) 414-7399.

What is Susan Budnick's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Susan Budnick enrolled in Medicare?

Yes. Susan Budnick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Susan Budnick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Budnick reassigns Medicare benefits to 4 organizations: Evans Medical Foundation, Inc. (Boston, MA), Inpatient Medical Services, Inc. (Hudson, OH), University Hospitals Medical Group Inc (Cleveland, OH) and 4M Hospitalist Services, LLC (Akron, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susan Budnick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Susan Budnick accept?

Health plans from CareSource and WellSense Health Plan list Susan Budnick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Susan Budnick affiliated with any hospitals?

According to CMS data, Susan Budnick is affiliated with Boston Medical Center.

When was this NPI record last updated?

The NPPES record for Susan Budnick was last updated on June 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.