Organization Active NPI

Michael Bush MD PLLC

  • Specialist
  • Tucson, AZ
National Provider Identifier
1942420641
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
14105 Issued in AZ
Legal business name
MICHAEL BUSH MD PLLC
Practice address
4323 E 5TH St
#C
Tucson, AZ 85711-2088
Phone
(520) 795-6900
Fax
(520) 795-2951
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michael K Bush, MD
Title
Owner
Phone
(520) 795-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 14105 AZ Primary

Addresses

Primary practice location

4323 E 5TH St
#C
Tucson, AZ 85711-2088

Mailing address

4323 E 5TH St
#C
Tucson, AZ 85711-2088
Phone (520) 795-6900

Other identifiers 2

IdentifierTypeStateIssuer
AZ0079201OtherAZBLUE CROSS BLUE SHIELD
253526MedicaidAZ

Other names 1

  • Advanced Hemorrhoid Care Other name

National Provider Directory

National Provider Directory

Locations

4323 E 5th St
Ste C
Tucson, AZ 85711
Phone (520) 795-6900

4323 E 5th St
#C
Tucson, AZ 85711
Phone (520) 795-6900

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942420641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 E 5TH ST",
            "address_2": "#C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112088",
            "telephone_number": "520-795-6900",
            "fax_number": "520-795-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 E 5TH ST",
            "address_2": "#C",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112088",
            "telephone_number": "520-795-6900",
            "fax_number": "520-795-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL BUSH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-795-6900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "14105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0079201",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253526",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Hemorrhoid Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.