Individual provider Active NPI

Adrael Asai Bushman, LCSW

  • Clinical Social Worker
  • Hamburg, NY
National Provider Identifier
1780299784
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
097111 Issued in NY
Practice address
4535 Southwestern Blvd Ste 802
Hamburg, NY 14075-1860
Phone
(716) 201-0442
NPI assigned
Sep 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 097111 NY Primary

Addresses

Primary practice location

4535 Southwestern Blvd Ste 802
Hamburg, NY 14075-1860

Mailing address

4535 Southwestern Blvd Ste 802
Hamburg, NY 14075-1860
Phone (716) 201-0442

Other names 1

  • Adrael Asai Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251118000729 NY Practitioner - Clinical Social Worker 8628569662 Practice locations: Hamburg, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4535 Southwestern Blvd
Suite 802
Hamburg, NY 14075-1860
Phone (716) 201-0442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
097111NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bestself Behavioral Health, Inc. PastSince Oct 11, 2020 Accepting new patients

Organizations & group practices 1

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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1780299784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 SOUTHWESTERN BLVD STE 802",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140751860",
            "telephone_number": "716-201-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 SOUTHWESTERN BLVD STE 802",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140751860",
            "telephone_number": "716-201-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHMAN",
        "first_name": "ADRAEL",
        "middle_name": "ASAI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRAEL",
            "last_name": "JOHNSON",
            "middle_name": "ASAI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.