Chelsea L Bustamante, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9330519 Issued in FL

Practice address

1945 Bay Rd
Mount Dora, FL 32757-2105

Phone

(352) 483-5633

NPI assigned

May 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Chelsea L Wallace Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Manoogian Orthopedic Center PAGroup PAC ID 6507826096, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
• Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084
• Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290

Merit-based Incentive Payment System (MIPS)

Final score

94.52 of 100Reported as group

Quality

100

Improvement activities

40

Cost

76.91

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: cbustamante725892@direct.shands.ufl.edu

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.

• Manoogian Orthopedic Center, P.a.

  • Orthopaedic Surgery Physician
  • Mount Dora, FL
  • NPI 1205945763
  Medicare reassignment Care Compare group NPD

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

• Florida Hospital Waterman Inc

  • General Acute Care Hospital
  • Tavares, FL
  • NPI 1821019571
  Care Compare affiliation
• Leesburg Regional Medical Center Inc

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1245001189

  Hospital

  Care Compare affiliation
• Leesburg Regional Medical Center Inc

  • General Acute Care Hospital
  • Leesburg, FL
  • NPI 1245226190
  Care Compare affiliation
• LRMC Urgent Care Center

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1598841389

  Hospital

  Care Compare affiliation
• Villages Tri-County Medical Center Inc.

  • General Acute Care Hospital
  • The Villages, FL
  • NPI 1740276518
  Care Compare affiliation

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1144718503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 TEMPIC DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327578033",
            "telephone_number": "352-551-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 BAY RD",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327572105",
            "telephone_number": "352-483-5633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Cranes Roost Blvd Ste 1220",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327013480",
            "country_code": "US",
            "telephone_number": "407-774-3325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "CHELSEA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9330519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHELSEA",
            "last_name": "WALLACE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Burke
• Michelle Burke
• Christopher Michael Burns, LCSW
• Donna G Burrell Swain, LMT
• Crystal Gale Bush - Callos
• Shaakirah Butts
• Kimberly Westbrook Capstraw, M.S.
• Christina Caraballo
• Amanda L Carbary
• Care America at Mount Dora, LLC

• Family Nurse Practitioner in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.