Individual provider Active NPI

Andrea Bushelle, M.D

  • Obstetrics & Gynecology Physician
  • New York, NY
National Provider Identifier
1295975811
Registry record updated Feb 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
197750 Issued in NY
Practice address
448 E 119TH St
New York, NY 10035-3626
Phone
(212) 369-5100
NPI assigned
Feb 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 197750 NY Primary

Addresses

Primary practice location

448 E 119TH St
New York, NY 10035-3626

Mailing address

448 E 119TH St
New York, NY 10035-3626
Phone (212) 369-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
197750NYMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1235174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235174400000",
    "number": "1295975811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 E 119TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353626",
            "telephone_number": "212-369-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 E 119TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353626",
            "telephone_number": "212-369-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHELLE",
        "first_name": "ANDREA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-21",
        "last_updated": "2009-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "197750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.