Ivan Jose Bustillo Chams, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

PT12924 Issued in ND

Practice address

Altru Cancer Center
960 S. Columbia Road
Grand Forks, ND 58201

Phone

(701) 780-5400

Fax

(203) 789-5184

NPI assigned

Sep 23, 2008

Last updated

Jan 29, 2025By 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 ND

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

Specialty

Hematology/OncologyAlso: Medical Oncology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru Hospital Hospital, Grand Forks, ND, CCN 350019
• Pembina County Memorial Hospital Hospital, Cavalier, ND, CCN 351319
• First Care Health Center Hospital, Park River, ND, CCN 351326
• Lifecare Medical Center Hospital, Roseau, MN, CCN 241344
• Unity Medical Center Hospital, Grafton, ND, CCN 351320

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Altru Health System

  dba Altru 1300 Columbia

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• Altru Health System

  dba Altru Care Flight

  • Ambulance
  • Grand Forks, ND
  • NPI 1114485315
  NPD
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  NPD
• Altru Health System

  dba Altru Health System (Prosthetics and Orthotics)

  • Prosthetic/Orthotic Supplier
  • Grand Forks, ND
  • NPI 1033257704
  NPD (past)
• Clinic Pharmacy Inc

  • Community/Retail Pharmacy
  • Devils Lake, ND
  • NPI 1184718876
  NPD (past)
• Altru Health System

  dba Altru Clinic - East Grand Forks

  • Clinic/Center
  • East Grand Forks, MN
  • NPI 1740621556
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161
  Care Compare affiliation
• Christian Unity Hospital Corporation

  dba Unity Medical Center

  • Critical Access Hospital
  • Grafton, ND
  • NPI 1245216852
  Care Compare affiliation
• P R Health Corporation

  dba First Care Health Center

  • Critical Access Hospital
  • Park River, ND
  • NPI 1679669741
  Care Compare affiliation
• Pembina County Memorial Hospital Association

  • Critical Access Hospital
  • Cavalier, ND
  • NPI 1760542500
  Care Compare affiliation
• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Care Compare affiliation

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1457501827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13780",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58208",
            "telephone_number": "701-780-1891",
            "fax_number": "203-789-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ALTRU CANCER CENTER",
            "address_2": "960 S. COLUMBIA ROAD",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-5400",
            "fax_number": "203-789-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTILLO CHAMS",
        "first_name": "IVAN",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-23",
        "last_updated": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ND",
            "license": "PT12924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Joy Burris, PT
• Emily Bush, PMHNP
• Joyce Elizabeth Bushaw, COTA L
• Rachel Leeann Busko, MD
• Kassidy Danae Bustamante
• Buzick Counseling Services, PLLC (Beyond Therapy ND)
• Amber Buzick, LCSW, LICSW
• Robert Joseph Buzick
• Michael J Bydal, MA
• Norman T Byers, MD

• Hematology & Oncology Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Hematology & Oncology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.
• 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.