KELLY ANN BUSH M.D.
NPI 1073831079
Pediatrics - Pediatric Hematology-Oncology in San Diego, CA

Q: What is Kelly Bush's NPI number?

The NPI number for Kelly Bush is 1073831079. It was assigned to this individual provider in the NPPES registry on May 14, 2010.

Q: What is Kelly Bush's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Bush was last updated on June 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 14, 2010PECOS EnrolledAccepts Medicare Assignment

3010 CHILDRENS WAY, SAN DIEGO, CA 92123(858) 966-5811 Get Directions Write a Review

NPPES record last updated: June 18, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 18, 2020, Jul 18, 2019, Aug 8, 2018 and 1 more (4 updates tracked since 2017).

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About Kelly Ann Bush M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ANN BUSH M.D. (NPI 1073831079) is an individual pediatric hematology-oncology provider in San Diego, California, licensed in California (A125141) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS and is a graduate of New York Medical College (2010).

NPPES Registry Identity

NPI1073831079

Entity TypeIndividualFemale

Primary Taxonomy2080P0207X

Provider Legal NameKELLY ANN BUSHCredential: M.D.

Location Address3010 CHILDRENS WAYSan Diego, CA 92123-4223

Mailing Address3020 Childrens Way # Mc5003San Diego, CA 92123-4223 · (858) 309-6300

Phone(858) 966-5811

Sole ProprietorNo

Medical School CMSNew York Medical CollegeGraduated 2010

Enumeration DateMay 14, 2010

Last NPPES UpdateJune 18, 20204 updates tracked since enumeration

NPPES CertifiedJune 18, 2020

✔ NPI 1073831079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0207X

License✔ Licensed in CA · A125141

Definition

A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.

Also ListedPediatricsTaxonomy 208000000X · License A125141 (CA)

3010 CHILDRENS WAY, San Diego, CA 92123

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Ann Bush M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789800749

PECOS Enrollment IDI20200929000751

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KATHERINE N. NYMAN MD

Pediatrics (Neonatal-Perinatal Medicine)