JEFFERY B BUSHMAN DO PC — NPI 1598009722 (Licensed & Credentialed Exclusive Provider Organization in WILLCOX, AZ)

CMS-1500 Box 24J / 33a • NPI

1598009722

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

302F00000X

Licensed & Credentialed Exclusive Provider Organization

Box 32 Service Location & ZIP+4

905 N BOWIE AVE, WILLCOX, AZ, 85643-1145

✓ 9-Digit EDI 837 ZIP+4 (85643-1145)

Practice Phone & Referral Fax

(520) 384-4291

Fax: (520) 384-3055

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1598009722 (JEFFERY B BUSHMAN DO PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1598009722` (NPI-2 Organization / Facility)
Provider / Legal Name	JEFFERY B BUSHMAN DO PC
Plain-English Specialty	Licensed & Credentialed Exclusive Provider Organization NUCC Code: `302F00000X` (Exclusive Provider Organization)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	905 N BOWIE AVE, WILLCOX, AZ, 85643-1145
Practice Telephone / Fax	Tel: (520) 384-4291 \| Fax: (520) 384-3055
Administrative Mailing Address	PO BOX 1115, WILLCOX, AZ, 85644-1115
Enumeration & Last Sync	Enumerated: 2012-11-10 \| CMS Record Updated: 2012-11-10
Authorized Official	JEFFERY BUSHMAN (Owner/Physician)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

905 N BOWIE AVE, WILLCOX, AZ, 85643-1145

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Plain-English Taxonomy & CMS Crosswalk (302F00000X)

What Does Taxonomy Code 302F00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 302F00000X translates to:
"Licensed & Credentialed Exclusive Provider Organization"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Exclusive Provider Organization for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JEFFERY B BUSHMAN DO PC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`302F00000X` — Exclusive Provider Organization Plain English: Licensed & Credentialed Exclusive Provider Organization	State: AZ \| License: `2338` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JEFFERY B BUSHMAN DO PC (NPI #1598009722)