Rafael Miguel Bustamante, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

ME137233 Issued in FL

Practice address

1601 S Andrews Ave FL 3
Fort Lauderdale, FL 33316-2509

Phone

(954) 320-3380

Fax

(954) 320-3371

NPI assigned

Jun 17, 2010

Last updated

Aug 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Vascular Surgery

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Beach General Surgery LLCGroup PAC ID 1456455021, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Westside Regional Medical Center Hospital, Plantation, FL, CCN 100228
• HCA Florida University Hospital Hospital, Davie, FL, CCN 100360
• University Hospital and Medical Center Hospital, Tamarac, FL, CCN 100224
• HCA Florida Northwest Hospital Hospital, Margate, FL, CCN 100189

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: rafael.bustamante@hca4.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Palm Beach General Surgery LLC

  • Surgery Physician
  • Loxahatchee, FL
  • NPI 1235326760
  Medicare reassignment Care Compare group NPD
• Palm Beach General Surgery LLC

  • Surgery Physician
  • Atlantis, FL
  • NPI 1710040266
  NPD (past)

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

• Columbia Hospital Corporation of South Broward

  dba HCA Florida Westside Hospital

  • General Acute Care Hospital
  • Plantation, FL
  • NPI 1063466589
  Care Compare affiliation
• Davie Medical Center, LLC

  dba HCA Florida University Hospital

  • General Acute Care Hospital
  • Davie, FL
  • NPI 1871182956
  Care Compare affiliation
• Northwest Medical Center Inc

  dba HCA Florida Northwest Hospital

  • General Acute Care Hospital
  • Margate, FL
  • NPI 1063466563
  Care Compare affiliation
• University Hospital, LTD.

  dba HCA Florida Woodmont Hospital

  • General Acute Care Hospital
  • Tamarac, FL
  • NPI 1144274770
  Care Compare affiliation

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1164743837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-320-3380",
            "fax_number": "954-320-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S ANDREWS AVE FL 3",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162509",
            "telephone_number": "954-320-3380",
            "fax_number": "954-320-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "RAFAEL",
        "middle_name": "MIGUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN14979",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME137233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Heather Burton, PA-C, MHSC, BAS, BA
• Joseph William Bush
• Taylor Marie Bushing, PA-C
• Edgar Bustamante, MD
• Lemmer Ferrer Bustamante, PT
• Gaston Luis Bustos, PH.D., LMHC
• Rhea Butchey, O.D.
• George Butler, PSYD
• Muhammad Waleed Butt, M.D
• Butterfly Wold Care & Services, Inc

• Vascular Surgery Physician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Vascular Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.