Individual provider Active NPI

Eduardo M. Bustamante, PSYCHOLOGIST

  • Clinical Psychologist
  • Holyoke, MA
National Provider Identifier
1396960720
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3644 Issued in MA
Practice address
235 Maple St
Holyoke, MA 01040-5123
Phone
(413) 532-0389
Fax
(413) 534-3238
NPI assigned
Apr 13, 2007
Last updated
Mar 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3644 MA Primary

Addresses

Primary practice location

235 Maple St
Holyoke, MA 01040-5123

Mailing address

29 Pine Hill Rd
Easthampton, MA 01027-9760
Phone (413) 203-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070711000493 MA Practitioner - Clinical Psychologist 9335249986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Resilience PCGroup PAC ID 0244645919, 2 clinicians

Practice addresses (Care Compare)

30 Florence Ave
Holyoke, MA 01040-1813
Phone (413) 450-1525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Network Inc CurrentSince Mar 12, 2007 Accepting new patients
Behavioral Health Network, Inc CurrentSince Mar 12, 2007 Accepting new patients
The Center for Resilience, PC CurrentSince Nov 22, 2025 Accepting new patients

Locations

208 Race St
Holyoke, MA 01040

208 Race St
Ste 302
Holyoke, MA 01040
Phone (413) 230-0375

235 Maple St
Holyoke, MA 01040
Phone (413) 532-0389

40 Bobala Rd
Holyoke, MA 01040
Phone (413) 536-5473

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1396960720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PINE HILL RD",
            "city": "EASTHAMPTON",
            "state": "MA",
            "postal_code": "010279760",
            "telephone_number": "413-203-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MAPLE ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405123",
            "telephone_number": "413-532-0389",
            "fax_number": "413-534-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "EDUARDO",
        "middle_name": "M.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.