Rathna Bushan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME55449 Issued in FL

Practice address

1454 Madison Ave W
Immokalee, FL 34142-2200

Phone

(239) 965-8300

Fax

(239) 658-3175

NPI assigned

Feb 6, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hope Hospice and Community Services, Inc

  dba Hope Comfort Care Program

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1114225745
  Medicare reassignment NPD
• Collier Health Services Inc

  dba Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Immokalee, FL
  • NPI 1609827211
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780723577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11341 LONGWATER CHASE COURT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 MADISON AVE W",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341422200",
            "telephone_number": "239-965-8300",
            "fax_number": "239-658-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHAN",
        "first_name": "RATHNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME55449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME55449",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn M Bertram-Stewart, MD
• Best Care Community and Family Health Center Inc
• Vanessa Hazbun Brennan, DMD
• Emily Ann Brosseit, ARNP
• Issa Bryant, DDS
• Maleighna Laurel Cade, CCC-SLP
• Eileen Christine Calderon, PSYD
• Ruby Ann Cannon, DNP
• Christina Carrillo, DACM
• Julio C Casas, M.D.

• Pediatrics Physician in Immokalee, FL
• Providers in Immokalee, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.