Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyle D Busack, PA

Individual provider Physician Assistant · NPI 1609122126

Kyle D Busack, PA is a Physician Assistant in Rochester, Minnesota. Qualified in 2012, 14 years ago. Practices with Mayo Clinic, a 4,796-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
14
Licensed in
MN
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

200 1st St SW
Rochester, MN 55905-0001
Phone: (507) 284-2511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 11165 (MN)

Record details

NPI number1609122126
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 2, 2012
Last updated in NPPESOctober 9, 2020
Certification dateOctober 9, 2020
Mailing address200 1st St Sw, Rochester, MN 55905-0001

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Mayo Clinic — 4796 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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