Individual provider Active NPI

Rene S Bustamante, DOM, AP

  • Acupuncturist
  • Homestead, FL
National Provider Identifier
1124584230
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP4009 Issued in FL
Practice address
43 NE 15TH St
Homestead, FL 33030-4506
Phone
(786) 243-1909
NPI assigned
Feb 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP4009 FL Primary

Addresses

Primary practice location

43 NE 15TH St
Homestead, FL 33030-4506

Mailing address

14972 SW 173Rd Ter
Miami, FL 33187-6756
Phone (305) 542-4509

Other practice location 1

7480 SW 40th St Ste 840
Miami, FL 33155-6660
Phone (305) 814-9772

Other identifiers 1

IdentifierTypeStateIssuer
AP4009OtherFLAP4009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP4009FLMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Enlightened Health Restoration Acupuncturist CurrentSince Aug 25, 2025 Accepting new patients
Homestead Medical Clinic, P.a CurrentSince Aug 25, 2025 Accepting new patients

Locations

43 NE 15th St
Homestead, FL 33030
Phone (786) 243-1909

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1124584230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14972 SW 173RD TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331876756",
            "telephone_number": "305-542-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 NE 15TH ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304506",
            "telephone_number": "786-243-1909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7480 SW 40th St Ste 840",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331556660",
            "country_code": "US",
            "telephone_number": "305-814-9772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "RENE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DOM, AP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-13",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP4009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AP4009",
            "identifier": "AP4009",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.