ETHAN BUSHMAN
NPI 1447648605
Nurse Anesthetist, Certified Registered in Oakland, CA
About Ethan Bushman NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ETHAN BUSHMAN (NPI 1447648605) is an individual nurse anesthetist, certified registered in Oakland, California, licensed in California (95000254) and active in the NPI registry since December 2014.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ethan Bushman is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Ethan Bushman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Richmond, CA 94801
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
OAKLAND, CA 94611
OAKLAND, CA 94611
OAKLAND, CA 94611
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ethan Bushman's NPI number?
The NPI number for Ethan Bushman is 1447648605. It was assigned to this individual provider in the NPPES registry on December 22, 2014.
Where is Ethan Bushman located?
Ethan Bushman practices at 3600 Broadway, Oakland, CA 94611. The listed phone number is (510) 752-1000.
What is Ethan Bushman's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Ethan Bushman enrolled in Medicare?
Yes. Ethan Bushman is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Ethan Bushman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Bushman reassigns Medicare benefits to Permanente Medical Group Inc (Richmond, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ethan Bushman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Ethan Bushman was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Ethan Bushman · NPI 1447648605
Nurse Anesthetist, Certified Registered physician in Oakland, California. Individual provider, active in the CMS NPPES registry since December 22, 2014.
## Identity
- **NPI:** 1447648605 (Entity type: Individual)
- **Enumerated:** December 22, 2014
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 95000254 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3600 BROADWAY, Oakland, CA 94611-5730
- **Phone:** (510) 752-1000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1235226531, Richmond, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 3, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1447648605) · Data from the CMS NPPES public registry.