Mary Beth Bustos, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.020437 Issued in IL

Practice address

6050 Sterling Creek Rd
Portage, IN 46368-7752

Phone

(219) 763-8112

NPI assigned

Nov 22, 2019

Last updated

Jun 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 IL, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marybeth.bustos.p1@direct.northshorehealth.nextgenshare.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.

• Northshore Health Centers Inc

  dba NorthShore Regional Health Centers

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1114257300
  Medicare reassignment NPD
• Midwest Express Care 2, Inc

  • Urgent Care Clinic/Center
  • Willowbrook, IL
  • NPI 1548692890
  Medicare reassignment NPD
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
  • NPI 1336992999
  NPD
• Northshore Health Centers, Inc.

  dba NorthShore LaPorte Health Center

  • Federally Qualified Health Center (FQHC)
  • La Porte, IN
  • NPI 1417519000

  Family

  NPD
• Midwest Express Care 2, Inc

  dba Midwest Express Clinic

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1659952554
  NPD

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1306482518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16401 PEPPERWOOD TRL",
            "city": "ORLAND HILLS",
            "state": "IL",
            "postal_code": "604875648",
            "telephone_number": "708-522-2372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 STERLING CREEK RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463687752",
            "telephone_number": "219-763-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Deann Burgy, APRN, CNM
• Nancy Kathryn Burke, PHARMD
• Shauna Marie Burns, PT
• Bush MD PC
• Shane David Bush, M.D.
• C.a.R.E.S Enterprises LLC (Cares Nemt)
• C.a.R.E.S Resources
• Karen M Cadle, COTA
• Trainia Denice Caldwell
• Michael Patrick Callahan, MSW

• Family Nurse Practitioner in Portage, IN
• Providers in Portage, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.