NPIMap

Individual provider Active NPI

Leandro Nicolas Slipczuk Bustamante, MD, PHD

  • Cardiovascular Disease Physician
  • Philadelphia, PA
National Provider Identifier
1134431000
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD457092 Issued in PA
Practice address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone
(800) 346-7834
NPI assigned
Jul 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT196711 PA
Cardiovascular Disease Physician 207RC0000X MD457092 PA Primary

Addresses

Primary practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Mailing address

1516 Pine St
Philadelphia, PA 19102-4604
Phone (267) 455-2717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20191011000491 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0840578852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT196711PAMDInternal Medicine Physician
MD457092PAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Sep 19, 2016 Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Aug 17, 2019 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Montefiore Medical Center CurrentSince Aug 17, 2019 Accepting new patients
Einstein Practice Plan Inc Cardiovascular Disease CurrentSince Sep 19, 2016 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

99 Business Park Dr
Armonk, NY 10504
Phone (914) 219-8515

111 E 210th St
Bronx, NY 10467

1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444

1250 Waters Pl
Ph 7
Bronx, NY 10461
Phone (718) 920-5949

555 Taxter Rd
Elmsford, NY 10523
Phone (718) 920-2587

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

9880 Bustleton Ave
Ste 2
Philadelphia, PA 19115
Phone (215) 827-1500

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

5501 Old York Rd
Bldg 3RD
Philadelphia, PA 19141
Phone (215) 456-3930

Networks

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

Interoperability endpoints

  • Direct secure messaging: leandro.slipczukbustamant@direct.einstein.edu
  • Direct secure messaging: lslipczukb@montefioredirect.com

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 4

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1134431000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 PINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024604",
            "telephone_number": "267-455-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "800-346-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLIPCZUK BUSTAMANTE",
        "first_name": "LEANDRO",
        "middle_name": "NICOLAS",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT196711",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD457092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.