Individual provider Active NPI

Nathan Bushue, PA-C

  • Physician Assistant
  • Redmond, WA
National Provider Identifier
1073087110
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61501654 Issued in WA
Practice address
8301 161St Ave NE Ste 202
Redmond, WA 98052-3858
Phone
(425) 996-8592
Fax
(425) 968-5619
NPI assigned
Jan 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 61501654 WA Primary

Addresses

Primary practice location

8301 161St Ave NE Ste 202
Redmond, WA 98052-3858

Mailing address

8301 161St Ave NE Ste 202
Redmond, WA 98052-3858
Phone (259) 968-5924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240412002055 WA Practitioner - Physician Assistant 0244578615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lightheart Associates PSGroup PAC ID 2163889981, 45 clinicians

Practice addresses (Care Compare)

400 N 34TH St
Suite 320
Seattle, WA 98103-5296
Phone (206) 486-8270

7902 168TH Ave NE
Suite 101
Redmond, WA 98052-4445
Phone (425) 996-8592

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61501654WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Kathleen Worsley Past 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": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1073087110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 202",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "259-968-5924",
            "fax_number": "425-968-5619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 161ST AVE NE STE 202",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523858",
            "telephone_number": "425-996-8592",
            "fax_number": "425-968-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHUE",
        "first_name": "NATHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-11",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61501654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.