Individual provider Active NPI

Charles A Bush-Joseph, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Chicago, IL
National Provider Identifier
1821077736
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
036070386 Issued in IL
Practice address
1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Phone
(877) 632-6637
Fax
(708) 409-5179
NPI assigned
Jan 10, 2006
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 01079047A IN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036070386 IL Primary

Addresses

Primary practice location

1611 W Harrison St Ste 400
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Phone (877) 632-6637

Other practice location 1

9200 Calumet Ave Ste 300
Munster, IN 46321-2885
Phone (877) 632-6637

Other identifiers 5

IdentifierTypeStateIssuer
4120999OtherAETNA
DA4902OtherRAILROAD MEDICARE PTAN
207067OtherILMEDICARE PTAN LOCALITY 16
207073OtherILMEDICARE PTAN LOCALITY 15
P00202615OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110127000968 IL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 4082527940 Reassigns benefits to 2 organizations
I20170817003911 IN Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 4082527940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Michigan State University College of Human Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637

9601 Calumet Ave
Munster, IN 46321-2871
Phone (877) 632-6637

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036070386ILMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince May 8, 2003 Accepting new patients
Orthomidwest, PLLC Sports Medicine CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush, LLC CurrentSince Jan 1, 2004 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Ste 107
Chicago, IL 60612
Phone (312) 432-2513

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

963 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 725-8425

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

9200 Calumet Ave
Munster, IN 46321
Phone (219) 664-9232

9200 Calumet Ave
#300
Munster, IN 46321

9200 Calumet Ave
Ste 300
Munster, IN 46321
Phone (708) 236-2737

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

Interoperability endpoints

  • Direct secure messaging: charles.bush-joseph.1@12576.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1821077736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 Calumet Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212885",
            "country_code": "US",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH-JOSEPH",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IN",
            "license": "01079047A",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036070386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4120999",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DA4902",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 16",
            "identifier": "207067",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 15",
            "identifier": "207073",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00202615",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.