Individual provider Active NPI

Deborah Bush, FNP

  • Family Nurse Practitioner
  • Dunkirk, NY
National Provider Identifier
1033520580
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
339054 Issued in NY
Practice address
504 Central Ave
Dunkirk, NY 14048-2515
Phone
(716) 366-9008
Fax
(716) 366-3158
NPI assigned
May 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 339054 NY Primary
General Practice Registered Nurse 163WG0000X 18672 TN

Addresses

Primary practice location

504 Central Ave
Dunkirk, NY 14048-2515

Mailing address

504 Central Ave
Dunkirk, NY 14048-2515
Phone (716) 366-9008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140905000499 NY Practitioner - Nurse Practitioner 2365660263 Reassigns benefits to 2 organizations
I20220210000668 TN Practitioner - Nurse Practitioner 2365660263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
339054NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sisters of Charity Hospital of Buffalo New York Current Accepting new patients
Trinity Medical Wny PC CurrentSince Sep 4, 2018 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Sep 29, 2019 Accepting new patients
Revitalist CurrentSince Jan 24, 2022 Accepting new patients
Trinity Medical Wny PC CurrentSince Sep 4, 2018 Accepting new patients
Kaleida Health Past Accepting new patients

Locations

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

3435 Bailey Ave
Buffalo, NY 14215
Phone (716) 835-2966

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

2 Red Bush Ct
Johnson City, TN 37601
Phone (423) 283-4958

10608 Flickenger Ln
Knoxville, TN 37922
Phone (833) 917-3400

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1400284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1033520580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 CENTRAL AVE",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482515",
            "telephone_number": "716-366-9008",
            "fax_number": "716-366-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 CENTRAL AVE",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140482515",
            "telephone_number": "716-366-9008",
            "fax_number": "716-366-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "DEBORAH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-17",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339054",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TN",
            "license": "18672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunkirk, NY

Sources for this page

Verify at the official NPI Registry.