Individual provider Active NPI

Lisa M Bush, CRNP

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1306382171
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017336 Issued in PA
Practice address
37 S 40TH St
Philadelphia, PA 19104-3042
Phone
(215) 444-7470
Fax
(215) 764-6556
NPI assigned
Jan 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017336 PA Primary

Addresses

Primary practice location

37 S 40TH St
Philadelphia, PA 19104-3042

Mailing address

PO Box 746722
Atlanta, GA 30374-6722

Other practice location 1

3400 Civic Center Blvd
3rd floor
Phila, PA 19104-5127
Phone (215) 662-3318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170605000661 PA Practitioner - Nurse Practitioner 4486921921 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh - PA Physicians Group, PCGroup PAC ID 7517213879, 113 clinicians

Practice addresses (Care Compare)

3621 Aramingo Ave
Philadelphia, PA 19134-4607
Phone (312) 600-8484

37 S 40TH St
FL 2
Philadelphia, PA 19104-3042
Phone (215) 444-7470

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group Current Accepting new patients
Osh - PA Physicians Group, PC Family CurrentSince Mar 6, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 5, 2017 Accepting new patients
Main Line Healthcare CurrentSince Jun 15, 2022 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 5, 2017 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3621 Aramingo Ave
Philadelphia, PA 19134
Phone (312) 600-8484

3400 Civic Center Blvd
Fl 3
Philadelphia, PA 19104
Phone (215) 614-4100

37 S 40th St
Philadelphia, PA 19104
Phone (215) 444-7470

951 N 6th St
Ste 221
Reading, PA 19601
Phone (484) 207-2000

100 E Lancaster Ave
Ste 330W
Wynnewood, PA 19096
Phone (610) 645-6555

Organizations & group practices 5

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 2

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": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1306382171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746722",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746722",
            "fax_number": "215-349-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 S 40TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043042",
            "telephone_number": "215-444-7470",
            "fax_number": "215-764-6556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Civic Center Blvd",
            "address_2": "3rd floor",
            "address_purpose": "LOCATION",
            "city": "Phila",
            "state": "PA",
            "postal_code": "191045127",
            "country_code": "US",
            "telephone_number": "215-662-3318",
            "fax_number": "215-349-5680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.