Kelly J. Bustos, NURSE PRACTICTIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17546 Issued in CA

Practice address

71-511 Highway 111
Suite H
Rancho Mirage, CA 92270-4465

Phone

(760) 773-2200

Fax

(760) 773-2202

NPI assigned

Oct 1, 2008

Last updated

Mar 1, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbustos425223@direct.llu.edu

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.

• Rodolfo R. Batarse, MD, Medical Corporation

  • Nephrology Physician
  • Rancho Mirage, CA
  • NPI 1295024933
  Medicare reassignment NPD

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1467603159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71-511 HIGHWAY 111",
            "address_2": "SUITE H",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704465",
            "telephone_number": "760-773-2200",
            "fax_number": "760-773-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71-511 HIGHWAY 111",
            "address_2": "SUITE H",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704465",
            "telephone_number": "760-773-2200",
            "fax_number": "760-773-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "KELLY",
        "middle_name": "J.",
        "credential": "NURSE PRACTICTIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "17546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Burnett
• Amy Elizabeth Burns, COTA L
• Krista Lynn Burris, MD
• Burton C Blaurock OD (Elegant Eye Optometry)
• Robert Joseph Bush, MD
• Evelyn Caballero, M.D.
• Cabanas and Lee Dental Corporation (Rancho Mirage Dental Group)
• Carol Lynn Cabanas, D.D.S.
• Ricardo Gonzalez Cacdac, MD
• Robert Cacdac

• Family Nurse Practitioner in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.