Individual provider Active NPI

Michael A Busch, OT

  • Occupational Therapist
  • Bellevue, WA
National Provider Identifier
1376904318
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 60632584 Issued in WA
Practice address
1200 112TH Ave NE Ste C210
Bellevue, WA 98004-3740
Phone
(425) 999-3580
Fax
(425) 999-3122
NPI assigned
Mar 18, 2016
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 60632584 WA Primary
Hand Occupational Therapist 225XH1200X OT60632584 WA

Addresses

Primary practice location

1200 112TH Ave NE Ste C210
Bellevue, WA 98004-3740

Mailing address

7683 SE 27TH St Ste 254
Mercer Island, WA 98040-2804
Phone (425) 999-3580

Other practice location 1

32030 23rd Ave S
Federal Way, WA 98003-6031
Phone (253) 946-4852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160323002372 WA Practitioner - Occupational Therapist in Private Practice 0941507651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

16222 Meridian E
Suite 101
Puyallup, WA 98375-6332
Phone (253) 864-7595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 60632584WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Occupational Therapist CurrentSince Oct 6, 2021 Accepting new patients
Multicare Health System CurrentSince Oct 6, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Occupational Therapist Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

16222 Meridian E
Ste 101
Puyallup, WA 98375
Phone (253) 846-7595

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1376904318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7683 SE 27TH ST STE 254",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402804",
            "telephone_number": "425-999-3580",
            "fax_number": "425-999-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 112TH AVE NE STE C210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043740",
            "telephone_number": "425-999-3580",
            "fax_number": "425-999-3122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32030 23rd Ave S",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980036031",
            "country_code": "US",
            "telephone_number": "253-946-4852",
            "fax_number": "253-946-4862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT 60632584",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "OT60632584",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.