Frederic Ransom Bushnell III, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A74349 Issued in CA

Practice address

909 South Fair Oaks Avenue
Pasadena, CA 91105-2625

Phone

(626) 389-9300

Fax

(626) 389-9336

NPI assigned

Jul 26, 2006

Last updated

May 9, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Valley Medical Group

  • Anesthesiology Physician
  • Pasadena, CA
  • NPI 1851312862
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Pasadena, CA
  • NPI 1871043224
  Medicare reassignment NPD
• Shriners Hospitals for Children

  dba Shriners Children's Hawaii

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD
• St. Vincent Anesthesia Medical Group, Inc.

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1164535571
  NPD (past)
• Shriners Hospitals for Children

  • Children's Hospital
  • Shreveport, LA
  • NPI 1679617849
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1003830092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SHRINERS HOSPITALS FOR CHILDREN",
            "address_2": "PO BOX 8500",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788113",
            "telephone_number": "813-281-8478",
            "fax_number": "813-281-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SOUTH FAIR OAKS AVENUE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052625",
            "telephone_number": "626-389-9300",
            "fax_number": "626-389-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "FREDERIC",
        "middle_name": "RANSOM",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A74349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A743491",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A743490",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A743490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracey Bush, MSW, LCSW
• Zachary J Bush
• Chere Bushae
• Chancellor Bushee
• Ashley Marie Bushey
• Ivan Bustamante
• Kristina Bustamantes
• Arabelle Bustos - Van Ranzow, MSW
• Martha Bustos, PHDY
• Nathan Bustos

• Anesthesiology Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.