Individual provider Active NPI

John James Bushaw IV, OD

  • Optometrist
  • Birmingham, MI
National Provider Identifier
1871084723
Registry record updated Sep 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005131 Issued in MI
Practice address
800 S Adams Rd Ste 201
Birmingham, MI 48009-7008
Phone
(248) 644-8060
NPI assigned
May 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2019

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
Optometrist 152W00000X 4901005131 MI Primary

Addresses

Primary practice location

800 S Adams Rd Ste 201
Birmingham, MI 48009-7008

Mailing address

800 S Adams Rd Ste 201
Birmingham, MI 48009-7008
Phone (248) 644-8060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191021002561 MI Practitioner - Optometry 5092047282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakland Ophthalmic Surgery PCGroup PAC ID 6103829940, 8 clinicians

Practice addresses (Care Compare)

800 S Adams Rd
Suite 201
Birmingham, MI 48009-7008
Phone (248) 644-8060

Merit-based Incentive Payment System (MIPS)

Final score
83.18 of 100Reported as group
Quality
100
Improvement activities
40
Cost
43.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Ophthalmic Surgery PC CurrentSince Sep 1, 2019 Accepting new patients

Locations

800 S Adams Rd
Ste 201
Birmingham, MI 48009
Phone (248) 644-8060

4600 Investment Dr
Ste 130
Troy, MI 48098
Phone (248) 267-5045

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/93as17mb

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": "1527379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568937600000",
    "number": "1871084723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S ADAMS RD STE 201",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097008",
            "telephone_number": "248-644-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S ADAMS RD STE 201",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097008",
            "telephone_number": "248-644-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHAW",
        "first_name": "JOHN",
        "middle_name": "JAMES",
        "name_suffix": "IV",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-27",
        "last_updated": "2019-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

Verify at the official NPI Registry.