Individual provider Active NPI

David Bushey

  • Anesthesiology Physician
  • Saint Cloud, MN
National Provider Identifier
1760918809
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
69020 Issued in MN
Practice address
3701 12TH St N Ste 202
Saint Cloud, MN 56303-2253
Phone
(320) 258-3090
Fax
(320) 258-3095
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 69020 MN Primary

Addresses

Primary practice location

3701 12TH St N Ste 202
Saint Cloud, MN 56303-2253

Mailing address

3701 12TH St N Ste 202
Saint Cloud, MN 56303-2253
Phone (320) 258-3090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20210820002440 MN Practitioner - Anesthesiology 1254601172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Georgetown University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

3701 12TH St N
Suite 202
Saint Cloud, MN 56303-2253
Phone (320) 258-3090

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69020MNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
Centracare Clinic CurrentSince Jul 1, 2021 Accepting new patients

Locations

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

3701 12th St N
Ste 202
Saint Cloud, MN 56303
Phone (320) 258-3090

Interoperability endpoints

  • Direct secure messaging: dbushey582172@direct.centracare.com

Organizations & group practices 2

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 6

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1760918809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N STE 202",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032253",
            "telephone_number": "320-258-3090",
            "fax_number": "320-258-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N STE 202",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032253",
            "telephone_number": "320-258-3090",
            "fax_number": "320-258-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHEY",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "69020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.