SHERRILL D BUSBOOM (PA) – Medical Physician Assistant, NPI 1720046626

SHERRILL D BUSBOOM (PA) is a healthcare provider. based in Portage, Michigan. specializing in Medical Physician Assistant. They hold the professional credentials PA. They hold a License No. 5601001603 (MI). The NPI Number for SHERRILL D BUSBOOM (PA) is 1720046626

Main info

Female
45 Years Of Experience
Accepts Medicare Assignment
Name
SHERRILL D BUSBOOM (PA)
NPI
1720046626
Phone
(269) 324-0799
Address
3200 W Centre Ave
Enumeration Date
2 May 2006
Last Update Date
23 July 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6162527200
Graduation Year
1981 (45 years ago)
PAC ID
6507897139
Group Practice PAC ID
5597651836
Professional Enrollment ID
I20050824000180
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for SHERRILL D BUSBOOM (PA)

  • 3200 W Centre Ave

    Suite 203

    Portage, MI 490244889

    Phone: (269) 324-0799

    Fax: (269) 324-8013

    Type: Location

  • Metro Health Hospital, 5900, Byron Center Avenue Southwest, Wyoming, Kent County, Michigan, 49519, United States

    MEDICAL ADMINISTRATION

    WYOMING, MI 495199606

    Phone: (616) 252-3243

    Fax: (616) 252-0260

    Type: Mailing

  • Health Drive Southwest, Wyoming, Kent County, Michigan, 49315, United States

    WYOMING, MI 49519

    Phone: (616) 252-7264

    Fax: (616) 252-6977

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $17.

Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.

Last reported payment date: 2023-01-23 • Largest payer in this snapshot: HARMONY BIOSCIENCES LLC ($17).

Total Amount

$17

General + Research + Ownership

Payments

1

Total payment records

General Amount

$17

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
HARMONY BIOSCIENCES LLC$17
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: 2005-08-24

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
I20050824000180IPhysician AssistantMITBD

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 49024)

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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: 5597651836View full group profile
NameSpecialtyState
Internal MedicineMI
-MI
Nurse PractitionerMI
Physician AssistantMI
Hospitalist, Internal MedicineMI
-MI
Family PracticeMI
Physician AssistantMI
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

What is the registry number for SHERRILL D BUSBOOM (PA)?
The registry entry for SHERRILL D BUSBOOM (PA) shows NPI 1720046626.
Is SHERRILL D BUSBOOM (PA)'s NPI status active today?
Active status means SHERRILL D BUSBOOM (PA)'s NPI record is not deactivated in the public file.
Which specialty label fits SHERRILL D BUSBOOM (PA)?
NPPES ties SHERRILL D BUSBOOM (PA) to Medical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit SHERRILL D BUSBOOM (PA) in Portage, Michigan?
For routing, start with Portage, Michigan for SHERRILL D BUSBOOM (PA), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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