Individual provider Active NPI

Michael Scott Bush, PA-C

  • Physician Assistant
  • Seaford, DE
National Provider Identifier
1053616409
Registry record updated Jan 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
801 Middleford Rd
Seaford, DE 19973-3636
Phone
(302) 629-6611
NPI assigned
Jan 17, 2011
Last updated
Jan 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2011

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 NU Primary

Addresses

Primary practice location

801 Middleford Rd
Seaford, DE 19973-3636

Mailing address

801 Middleford Rd
Seaford, DE 19973-3636
Phone (302) 629-6611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20111130000141 MD Practitioner - Physician Assistant 8527237965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ydiprmc, LLCGroup PAC ID 3173897402, 29 clinicians

Practice addresses (Care Compare)

Salisbury, MD 21804
Phone 41033463513022

1001 Philadelphia Ave
Suite a
Ocean City, MD 21842-3735
Phone (443) 210-2598

12385 Ocean Gtwy
Ocean City, MD 21842-9576
Phone (443) 210-2595

1511 Ocean Hwy
Pocomoke City, MD 21851-3017
Phone (443) 210-2516

2425 N Salisbury Blvd
Salisbury, MD 21801-2138
Phone (443) 944-0196

300 Sunburst Hwy
Cambridge, MD 21613-2506
Phone (443) 210-2593

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1295222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295222400000",
    "number": "1053616409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733636",
            "telephone_number": "302-629-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MIDDLEFORD RD",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733636",
            "telephone_number": "302-629-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-17",
        "last_updated": "2011-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, DE

Sources for this page

Verify at the official NPI Registry.