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ETHAN BUSHMAN
NPI 1447648605
Nurse Anesthetist, Certified Registered in Oakland, CA

Active since December 22, 2014Accepts Medicare Assignment
3600 BROADWAY, OAKLAND, CA 94611(510) 752-1000 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 3, 2022, Nov 4, 2016 (2 updates tracked since 2016).

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. He is a graduate of Other (2014).

NPPES Registry Identity

NPI1447648605
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameETHAN BUSHMAN
Location Address3600 BROADWAYOakland, CA 94611-5730
Mailing Address3600 BroadwayOakland, CA 94611-5730
Phone(510) 752-1000
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateDecember 22, 2014
Last NPPES UpdateJanuary 3, 20222 updates tracked since enumeration
✔ NPI 1447648605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in CA · 95000254
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered Nurse · Critical Care MedicineTaxonomy 163WC0200X · License 686467 (CA)
3600 BROADWAY, Oakland, CA 94611
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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

Ethan Bushman 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 ID1153600028
PECOS Enrollment IDI20161116002382

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94611 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

OSAMA MOHAMED EL-SAYED MD, PHD
Internal Medicine
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-1000
TRAM KHUONG
Pharmacist
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-4200
CHRISTIAN F. SCHMUTZ MD
Psychiatry & Neurology (Psychiatry)
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-1000
CHRISTOPHER AARON HUDSON RT
Respiratory Therapist, Registered
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-8886
ADAM BUIE
Pharmacist
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-1000
DR. JUSTIN B FONG MD
Student in an Organized Health Care Education/Training Program
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-1000
JASMINE THAI LU MD
Student in an Organized Health Care Education/Training Program
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-1000
MARGARET COSGROVE DPT
Physical Medicine & Rehabilitation
3600 BROADWAY
OAKLAND, CA 94611
Alameda County (510) 752-1000

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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

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.