Leticia G Bustamante Sanchez, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R230927 Issued in MD

Practice address

2255 Crain Hwy Ste 107
Waldorf, MD 20601-3186

Phone

(301) 818-7272

NPI assigned

Oct 15, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leticia.bustamante.1@22802.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/22802/brand/1/csg/1/fhir/r4

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.

• Hispanic American Pediatrics & Family Care LLC

  • Primary Care Clinic/Center
  • Waldorf, MD
  • NPI 1093313652
  NPD Authorized official

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1194323758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 CRAIN HWY STE 107",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013186",
            "telephone_number": "301-818-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 CRAIN HWY STE 107",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013186",
            "telephone_number": "301-818-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5130 Duke St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223042955",
            "country_code": "US",
            "telephone_number": "703-751-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTAMANTE SANCHEZ",
        "first_name": "LETICIA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R230927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "address_1": "15912 Crain Hwy Unit B #259",
            "city": "Brandywine",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marcia Angella Burrell-Odeyemi, NURSE PRACTITIONER
• Jettanna Burruss- Clark
• Nakia Bush, DDS
• Ramon Bush
• Jacques Emile Bussiere, CSA
• Anatoli Andreevich Bute Gusaim
• Shanise Butler, LGSW
• Shirletta Butler, LCSW-C
• BWN Inc
• BWN Inc

• Family Nurse Practitioner in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.