Ellen Joyce Tabiando Bustillo, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

044572 Issued in NY

Practice address

2 Victory CT
Newburgh, NY 12550-1745

Phone

(845) 522-5480

NPI assigned

Mar 7, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York Physical and Occupational Therapy Services, PLLCGroup PAC ID 6305144775, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New York Physical and Occupational Therapy Services, PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1356703631
  Medicare reassignment Care Compare group NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1023765336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 CLINTON AVE APT 6",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012929",
            "telephone_number": "949-994-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 VICTORY CT",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125501745",
            "telephone_number": "845-522-5480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 Avenue Of The Americas Fl 11",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101050013",
            "country_code": "US",
            "telephone_number": "212-981-1977",
            "fax_number": "646-791-2595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTILLO",
        "first_name": "ELLEN JOYCE",
        "middle_name": "TABIANDO",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "012201",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "044572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genesis L Burks-Hemingway, REGISTERED NURSE
• Rayma Burnett-Biglane, D.O.
• Anne Burns, RN
• Rebecca Bush, PHARMD
• Monroe Bussey, CASAC
• Patricia Ann Butcher, RN
• Cynthia Butler, P.T.
• Joy A Butler, LCSW
• Larhonda Butler, MSED
• Sharon E Bywater, MSW LCSWR

• Physical Therapist in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.