NPIMap

Individual provider Active NPI

Daniel Bustamante, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • El Paso, TX
National Provider Identifier
1134411333
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
Q7658 Issued in TX
Practice address
4815 Alameda Ave
El Paso, TX 79905-7990
Phone
(915) 215-4956
NPI assigned
May 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Q7658 TX Primary
Hematology (Pathology) Physician 207ZH0000X Q7658 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD2014-0816 NM
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4815 Alameda Ave
El Paso, TX 79905-7990

Mailing address

440 Raynolds St.
Msc51015
El Paso, TX 79905-2709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180709002354 TX Practitioner - Pathology 1052546231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Southwestern Medical School at Dallas, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2014-0816NMMDAnatomic Pathology & Clinical Pathology Physician
Q7658TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso County Hospital District CurrentSince Oct 15, 2018 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Mar 23, 2018 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Mar 23, 2018 Accepting new patients
El Paso County Hospital District CurrentSince Oct 15, 2018 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
El Paso Children'S Physician Group Past Accepting new patients

Locations

2000 Transmountain Rd
Ste A
El Paso, TX 79911
Phone (915) 215-4956

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

4845 Alameda Ave
El Paso, TX 79905
Phone (915) 215-5700

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

5400 Alameda Ave
Bldg B
El Paso, TX 79905
Phone (915) 242-8402

Interoperability endpoints

  • Direct secure messaging: daniel.bustamante@direct.myhealthep.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1134411333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 RAYNOLDS ST.",
            "address_2": "MSC51015",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799057990",
            "telephone_number": "915-215-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-05",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "Q7658",
            "primary": true
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "TX",
            "license": "Q7658",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NM",
            "license": "MD2014-0816",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.