Mark Bustillo, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34.014542 Issued in OH

Practice address

2142 N Cove Blvd
Toledo, OH 43606

Phone

(419) 291-4000

NPI assigned

Jul 24, 2018

Last updated

Nov 17, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Emergency Medicine Specialists Inc

  • Emergency Medicine Physician
  • Kettering, OH
  • NPI 1588640791
  Medicare reassignment NPD
• Emergency Medicine Specialists, Inc

  • Emergency Medicine Physician
  • Xenia, OH
  • NPI 1083982888
  NPD
• Emergency Medicine Specialists, Inc

  • Emergency Medicine Physician
  • Springfield, OH
  • NPI 1104572841
  NPD
• Emergency Medicine Specialists Inc

  • Emergency Medicine Physician
  • Miamisburg, OH
  • NPI 1366428575
  NPD (past)
• Emergency Medicine Specialists, Inc.

  • Emergency Medicine Physician
  • Franklin, OH
  • NPI 1689062440
  NPD (past)

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1194202945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 NEWMARK DR STE 220",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425400",
            "telephone_number": "937-438-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43606",
            "telephone_number": "419-291-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Miamisburg Centerville Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453427615",
            "country_code": "US",
            "telephone_number": "937-384-8791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTILLO",
        "first_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.014542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rochelle E Bush
• Sarah Bush
• Willetta Marie Bush
• Asia Bussdieker
• Betsy A Bussdieker, MA, CCC-SLP
• Candilee Butler, MD
• Cayla Butler
• Chrystal Butler
• Latrell Renee Butler
• Lydia M Butler

• Emergency Medicine Physician in Toledo, OH
• Providers in Toledo, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.