Eduardo Alejandro Bustamante Jr., MD

Individual provider Active NPI Ophthalmology Physician · Woodruff, WI

NPI 1154711513 · NPPES record last updated Jun 21, 2024

Key facts

NPI
1154711513
Entity type
Individual (NPI type 1)
Primary specialty
Ophthalmology Physician 207W00000X
License
83664-20 (WI)
Practice address
PO Box 1520
Woodruff, WI 54568-1520
Phone
(715) 356-2262
Fax
(715) 356-2257
NPI assigned
Jan 23, 2015
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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.

Medicare Care Compare profile

Specialty
Ophthalmology
Education
Northwestern University Feinberg Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redman and Gelinas SC (5 clinicians)

Practice addresses (Care Compare)

698 S 4TH Ave
Park Falls, WI 54552-0068
Phone (715) 762-2300

Hospital & facility affiliations

  • Howard Young Medical Center Hospital · Woodruff, WI · CCN 520091
  • Marshfield Medical Center - Minocqua Hospital · Minocqua, WI · CCN 520212

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100 (individual)
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.03 of 100 (group)
Quality
78.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery418
Removal or shaving of skin growth1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240610001807 WI Practitioner - Ophthalmology 4183910664 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Redman & Gelinas SC Optometrist Current
since Jun 29, 2024
Accepting new patients
Redman & Gelinas SC Optometrist Current
since Jun 29, 2024
Accepting new patients
Redman & Gelinas SC Optometrist Past Accepting new patients

Locations

141 S Willow St
Ste 102
Eagle River, WI 54521
Phone (715) 479-9390

141B S Willow St
Eagle River, WI 54521

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

698 4th Ave S
Park Falls, WI 54552
Phone (715) 762-2300

Interoperability endpoints

  • Direct secure messaging: ebustamante@redmangelinaseyecare.intellechartdirect.net
  • Direct secure messaging: eduardo.bustamante.p1@direct.genstlereyecenter.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME144452 FL
Ophthalmology Physician 207W00000X 83664-20 WI Yes

Addresses

Primary practice location

PO Box 1520
Woodruff, WI 54568-1520

Mailing address

PO Box 1520
Woodruff, WI 54568-1520
Phone (715) 356-2262

Other practice location 1

2201 S 10th St
Fort Pierce, FL 34950-5382
Phone (772) 461-2020

Other providers in Woodruff, WI

All providers in Woodruff, WI · Ophthalmology Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.