Individual provider Active NPI

Allyson Bush, MD

  • Pediatric Gastroenterology Physician
  • Hollywood, FL
National Provider Identifier
1497117188
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME155191 Issued in FL
Practice address
1131 N 35TH Ave Ste 300
Hollywood, FL 33021-5403
Phone
(954) 265-4475
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME155191 FL Primary

Addresses

Primary practice location

1131 N 35TH Ave Ste 300
Hollywood, FL 33021-5403

Mailing address

1131 N 35TH Ave Ste 300
Hollywood, FL 33021-5403

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811000228 FL Practitioner - GastroenterologyPractitioner - Pediatric Medicine 4486947017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Pediatric Medicine
Education
University of Miami, LM Miller School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1131 N 35TH Ave
Hollywood, FL 33021-5403

1971 SW 172ND Ave
Suite 500
Miramar, FL 33029-5592
Phone (954) 265-4475

900 Glades Rd
Suite 501
Boca Raton, FL 33431-6421
Phone (954) 265-4475

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155191FLMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Aug 1, 2022 Accepting new patients
South Broward Hospital District Pediatric Gastroenterology CurrentSince Aug 1, 2022 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

1131 N 35th Ave
Ste 300
Hollywood, FL 33021
Phone (954) 265-1616

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1497117188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 N 35TH AVE STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N 35TH AVE STE 300",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215403",
            "telephone_number": "954-265-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "ALLYSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME155191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.