Briana Radosevich Bustos, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6212 Issued in NM

Practice address

1350 Hillrise Cir
Las Cruces, NM 88011

Phone

(575) 522-9500

NPI assigned

Jun 14, 2017

Last updated

Jun 14, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Espanola Sports Medicine PAGroup PAC ID 2163691411, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Espanola Sports Medicine, PA

  dba Espanola Sports Medicine

  • Rehabilitation Clinic/Center
  • Espanola, NM
  • NPI 1982777850
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1164952958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 HILLRISE CIR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HILLRISE CIR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "575-522-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "BRIANA",
        "middle_name": "RADOSEVICH",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "6212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennica Bustamante
• Manuel A. Bustamante
• Noemi Correa Bustillos, COTA/L
• Samantha Lyn Bustillos, NURSE PRACTITIONER
• Samuel Correa Bustillos, ACNP-AG
• Busy Bee Psychological Services Inc
• Ashley J Butler IV, MCJ, MPA
• Karen Marie Butler
• Stephanie Cuellar Butler
• Laura Michelle Butner

• Speech-Language Pathologist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Speech-Language Pathologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.