NPIMap

Individual provider Active NPI

Michael Allan Bidus, M.D.

  • Gynecologic Oncology Physician
  • Gig Harbor, WA
National Provider Identifier
1235192584
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
MD60391889 Issued in WA
Practice address
11511 Canterwood Blvd NW Ste 100
Gig Harbor, WA 98332
Phone
(253) 382-8150
Fax
(253) 382-8155
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X MD60391889 WA Primary
Gynecologic Oncology Physician 207VX0201X MD060320L PA

Addresses

Primary practice location

11511 Canterwood Blvd NW Ste 100
Gig Harbor, WA 98332

Mailing address

8166 Mississippi Rd
Laurel, MD 20724-6123
Phone (240) 418-2979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20240409004349 SD Practitioner - Gynecological Oncology 4183890890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Georgetown University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2114

1000 E 23Rd St
Sioux Falls, SD 57105-2140

1001 E 21St St
Suite 401
Sioux Falls, SD 57105-1017
Phone (605) 322-8920

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

1417 S Cliff Ave
Suite 401
Sioux Falls, SD 57105-1064
Phone (605) 322-8920

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 322-6930

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Avera St Mary'S Hospital Hospital, Pierre, SD, CCN 430015
  • Avera Queen of Peace Hospital, Mitchell, SD, CCN 431340
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • Avera St Lukes Hospital, Aberdeen, SD, CCN 430014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus30

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD060320LPAMDGynecologic Oncology Physician
MD60391889WAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Feb 7, 2024 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Gynecologic Oncology CurrentSince Feb 7, 2024 Accepting new patients

Locations

1417 S Cliff Ave
Ste 401
Sioux Falls, SD 57105
Phone (605) 322-8920

Organizations & group practices 3

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1235192584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8166 MISSISSIPPI RD",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207246123",
            "telephone_number": "240-418-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD NW STE 100",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "98332",
            "telephone_number": "253-382-8150",
            "fax_number": "253-382-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIDUS",
        "first_name": "MICHAEL",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "WA",
            "license": "MD60391889",
            "primary": true
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "PA",
            "license": "MD060320L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.