Individual provider Active NPI

Sarah Renee Bush, PA-C

  • Physician Assistant
  • Hollywood, FL
National Provider Identifier
1033972336
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9118364 Issued in FL
Practice address
3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915
Phone
(305) 466-9988
Fax
(305) 466-9989
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9118364 FL Primary

Addresses

Primary practice location

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915

Mailing address

3800 S Ocean Dr Ste 209
Hollywood, FL 33019-2915
Phone (305) 466-9988

Other practice location 1

24632 State Road 54
Lutz, FL 33559-7307
Phone (813) 948-6335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240814002159 GA Practitioner - Physician Assistant 0345788956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9118364FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bush, Dr. P.a. PastSince Feb 1, 2024 Accepting new patients

Organizations & group practices 2

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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1033972336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S OCEAN DR STE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192915",
            "telephone_number": "305-466-9988",
            "fax_number": "305-466-9989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24632 State Road 54",
            "address_purpose": "LOCATION",
            "city": "Lutz",
            "state": "FL",
            "postal_code": "335597307",
            "country_code": "US",
            "telephone_number": "813-948-6335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "SARAH",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9118364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.