NPIMap

Individual provider Active NPI

Amanda Jo Bush, M.D.

  • Gynecology Physician
  • Belvidere, IL
National Provider Identifier
1093950941
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
N3526 Issued in TX
Practice address
1700 Henry Luckow LN
Belvidere, IL 61008
Phone
(779) 696-8650
NPI assigned
Dec 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X N3526 TX
Gynecology Physician 207VG0400X MB0755263A MA
Gynecology Physician 207VG0400X 036.125964 IL
Gynecology Physician 207VG0400X N3526 TX Primary

Addresses

Primary practice location

1700 Henry Luckow LN
Belvidere, IL 61008

Mailing address

PO Box 78866 Swedishamerican Medical Group
Milwaukee, WI 53278-8866
Phone (779) 696-7150

Other names 1

  • Miss Amanda Jo Turner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210504001966 TX Practitioner - Obstetrics/Gynecology 0941496855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6201 Harry Hines Blvd
Dallas, TX 75235-5202
Phone (214) 633-5555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.125964ILMDGynecology Physician
MB0755263AMAMDGynecology Physician
N3526TXMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Obstetrics & Gynecology CurrentSince May 3, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince May 3, 2021 Accepting new patients
Dallas County Hospital District Past Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

Organizations & group practices 4

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.

Hospital & facility affiliations 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1228521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1093950941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866 SWEDISHAMERICAN MEDICAL GROUP",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150",
            "fax_number": "779-696-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "61008",
            "telephone_number": "779-696-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-06",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "N3526",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MA",
            "license": "MB0755263A",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": "036.125964",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "N3526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "TURNER",
            "middle_name": "JO",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Belvidere, IL

Sources for this page

Verify at the official NPI Registry.