KELLY ANN BUSH (M.D.) – Pediatric Hematology & Oncology Physician, NPI 1073831079

KELLY ANN BUSH (M.D.) is a healthcare provider. based in San diego, California. specializing in HEMATOLOGY/ONCOLOGY, PEDIATRIC MEDICINE. They hold the professional credentials M.D.. They hold a License No. A125141 (CA). The NPI Number for KELLY ANN BUSH (M.D.) is 1073831079

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
KELLY ANN BUSH (M.D.)
NPI
1073831079
Phone
(858) 966-5811
Address
3010 CHILDRENS WAY
Enumeration Date
14 May 2010
Last Update Date
18 June 2020

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
8585761700
Graduation Year
2010 (16 years ago)
PAC ID
4789800749
Group Practice PAC ID
3971677493
Professional Enrollment ID
I20200929000751
Address ID
CA921234223SA3020XWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:16State licenses:1Digital endpointsOther names

1,531 HEMATOLOGY/ONCOLOGY in CA

Provider Addresses for KELLY ANN BUSH (M.D.)

  • 3010 CHILDRENS WAY

    SAN DIEGO, CA 921234223

    Phone: (858) 966-5811

    Type: Location

  • 3020 CHILDRENS WAY # MC5003

    SAN DIEGO, CA 921234223

    Phone: (858) 309-6300

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $190.

Total Amount is formed as General ($190) + Research ($0) + Ownership ($0) = $190.

Last reported payment date: 2024-09-14 • Largest payer in this snapshot: GENZYME CORPORATION ($121).

Total Amount

$190

General + Research + Ownership

Payments

4

Total payment records

General Amount

$190

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-09-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200929000751IPediatric MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92123)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971677493View full group profile
NameSpecialtyState
P A T H O L O G YCA
-CA
Infectious Disease, Pediatric MedicineCA
-CA
Infectious Disease, Pediatric MedicineCA
O T O L A R Y N G O L O G YFL
Pediatric MedicineCA
O P H T H A L M O L O G YCT
Orthopedic SurgeryCA
Pulmonary Disease, Pediatric MedicineCO

Reviews

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Frequently asked questions

Where can patients find KELLY ANN BUSH (M.D.)'s NPI?
You can confirm KELLY ANN BUSH (M.D.) with NPI 1073831079; it appears in the national provider directory.
Is KELLY ANN BUSH (M.D.)'s NPI currently valid?
The extract we use shows KELLY ANN BUSH (M.D.) as active.
What kind of provider is KELLY ANN BUSH (M.D.)?
The page reflects Pediatric Hematology & Oncology Physician for KELLY ANN BUSH (M.D.). Clinical services aligned with this taxonomy classification.
What location shows for KELLY ANN BUSH (M.D.)?
We surface San Diego, California for KELLY ANN BUSH (M.D.) based on available NPPES addresses.
Is KELLY ANN BUSH (M.D.) a real provider?
This page reflects official NPPES data for NPI 1073831079. Always confirm identity and privileges with the practice and licensing boards.

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