Randy Joseph Brush, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

99054700A Issued in IN

Practice address

6301 University Commons
Suite 210
South Bend, IN 46635-1571

Phone

(574) 234-4016

Fax

(574) 251-2095

NPI assigned

Nov 27, 2012

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

Medicare fee-for-service enrollment

Enrolled in IN, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pic Indiana PCGroup PAC ID 3476790239, 143 clinicians

Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Lakeshore Bone and Joint Institute, PCGroup PAC ID 3173500519, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: randybrush@fmsbpc.allscriptsdirect.net
• Direct secure messaging: r.brush@lbji.exscribedirect.com

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.

• Lakeshore Bone & Joint Institute, PC

  • Specialist
  • Chesterton, IN
  • NPI 1508853953
  Medicare reassignment Care Compare group NPD
• Pic Indiana PC

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1942546890
  Medicare reassignment Care Compare group
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment Care Compare group
• Family Medicine of South Bend PC

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1356432538
  Medicare reassignment
• Wellnow Urgent Care, PC

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162

  IL

  Medicare reassignment
• Lakeshore Bone & Joint Institute, PC

  • Specialist
  • Michigan City, IN
  • NPI 1194999888
  NPD

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1902141237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "address_2": "SUITE 210",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-234-4016",
            "fax_number": "574-251-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "address_2": "SUITE 210",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-234-4016",
            "fax_number": "574-251-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSH",
        "first_name": "RANDY",
        "middle_name": "JOSEPH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "99054700A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Bruinsma, PSYD
• Ellen Bruneel, OTR
• Mary Joan Brunner
• Seth David Brunner, DPT
• Ashley Brunt, LSW
• Connie Marie Bryan, RN
• Geraldne F Bryan, MSW, LCSW
• Nancy Bryant, LCSW
• Janiah Buchanon, RBT
• Kaedon Izaac Buchmiller, DO

• Medical Physician Assistant in South Bend, IN
• Providers in South Bend, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.