Individual provider Active NPI

Todd Michael Bush, PA-C

  • Surgical Physician Assistant
  • Boston, MA
National Provider Identifier
1760615587
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1816 Issued in MA
Practice address
110 Francis St
Suite 2a
Boston, MA 02215-5501
Phone
(617) 632-8383
Fax
(617) 632-7562
NPI assigned
Aug 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA1816 MA Primary

Addresses

Primary practice location

110 Francis St
Suite 2a
Boston, MA 02215-5501

Mailing address

110 Francis St
Suite 2a
Boston, MA 02215-5501
Phone (617) 632-8383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20100520000258 MA Practitioner - Physician Assistant 8224167861 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

1 Deaconess Rd
Boston, MA 02215-5321
Phone (781) 983-9088

114 N Beacon St
Suite 116
Brighton, MA 02135-2011
Phone (781) 983-9088

116 N Beacon St
Brighton, MA 02135-2011
Phone (617) 783-5200

330 Brookline Ave
Boston, MA 02215-5400

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 22, 2020 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Oct 22, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2019 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
#2
Boston, MA 02215
Phone (617) 632-8383

110 Francis St
Ste 2A
Boston, MA 02215
Phone (617) 632-7390

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Interoperability endpoints

  • Direct secure messaging: tbush252590@direct.bilh.masshiway.net

Organizations & group practices 6

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 1

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": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251331200000",
    "number": "1760615587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST",
            "address_2": "SUITE 2A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-8383",
            "fax_number": "617-632-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST",
            "address_2": "SUITE 2A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-8383",
            "fax_number": "617-632-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA1816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.