NPIMap

Individual provider Active NPI

Carly Bushman, M.D.

  • Family Medicine Physician
  • Levittown, NY
National Provider Identifier
1821416629
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
289752 Issued in NY
Practice address
3276 Hempstead Tpke
Levittown, NY 11756-1345
Phone
(516) 796-2273
NPI assigned
Mar 31, 2014
Last updated
Apr 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 289752 NY Primary

Addresses

Primary practice location

3276 Hempstead Tpke
Levittown, NY 11756-1345

Mailing address

93 Gardiners Ave
Levittown, NY 11756-3704
Phone (516) 455-7729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170803002372 NY Practitioner - Family Practice 4880965219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Suffolk HospitalGroup PAC ID 4981508082, 94 clinicians
Kim Medical of New York PLLCGroup PAC ID 6002299310, 17 clinicians

Practice addresses (Care Compare)

1 Heroes Way
Riverhead, NY 11901-2054
Phone (631) 548-6101

10 Maple St
Port Washington, NY 11050-2905
Phone (917) 746-5942

255 Executive Dr
Suite 210B
Plainview, NY 11803-1711
Phone (833) 433-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Suffolk Hospital CurrentSince Aug 10, 2017 Accepting new patients
Sumaiyah Medical PC CurrentSince Oct 31, 2024 Accepting new patients
Central Suffolk Hosptial CurrentSince Aug 10, 2017 Accepting new patients
Central Suffolk Hospital Past Accepting new patients

Locations

1 Somerset St
Huntington Station, NY 11746
Phone (631) 271-3075

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

Interoperability endpoints

  • Direct secure messaging: cbushman65416@northwell.direct-ci.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.

Hospital & facility affiliations 7

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1821416629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 GARDINERS AVE",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563704",
            "telephone_number": "516-455-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3276 HEMPSTEAD TPKE",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117561345",
            "telephone_number": "516-796-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHMAN",
        "first_name": "CARLY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "289752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

Verify at the official NPI Registry.