Active NPI
Catherine Bustios
- Pediatric Nurse Practitioner
- Rockville, MD
National Provider Identifier
1154869162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- R203090
- Practice address
- 15204 Omega Dr Ste 100
Rockville, MD 20850-4812 - Phone
- (443) 224-0706
- NPI assigned
- Feb 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R203090 | MD | Primary |
Addresses
Primary practice location
15204 Omega Dr Ste 100
Rockville, MD 20850-4812
Mailing address
1507 Gridley LN
Silver Spring, MD 20902-3843
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
| License | State | Type | Specialty |
|---|---|---|---|
| R203090 | MD | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1154869162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1507 GRIDLEY LN",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209023843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15204 OMEGA DR STE 100",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208504812",
"telephone_number": "443-224-0706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTIOS",
"first_name": "CATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-09",
"last_updated": "2023-11-02",
"certification_date": "2023-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MD",
"license": "R203090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.