Paul Michael De Bustros

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

036.169593 Issued in IL

Practice address

11516 183Rd PL Ste SE
Orland Park, IL 60467-9456

Phone

(708) 915-6807

NPI assigned

Mar 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

Loyola University of Chicago, Stritch School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Retina Associates, PLLCGroup PAC ID 6709799810, 19 clinicians

Eye Center Physicians, LTD.Group PAC ID 2567411325, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119
• Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224
• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pdebustros@illret.intellechartdirect.net
• Direct secure messaging: pdebustros102715@direct.luhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eye Center Physicians, LTD.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1992715650
  Medicare reassignment Care Compare group NPD
• Illinois Retina Associates PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Orland Park, IL
  • NPI 1225038870

  IN

  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD

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

• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation
• Presence Chicago Hospitals Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1679659585
  Care Compare affiliation
• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1487230876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E WATERSIDE DR UNIT 2808",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606014730",
            "telephone_number": "708-567-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11516 183RD PL STE SE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679456",
            "telephone_number": "708-915-6807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "888-584-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE BUSTROS",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036.169593",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036.169593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Michelle Davis, DO
• Terene Davis, COTA
• Nancy Dawkins, LCSW
• Sabrina Dawud, DMD
• Carolyn E. Day, OTR/L
• Kathy J De Vries, M.A., L.C.P.C.
• Monica J Decicco, WHNP
• Lazma Deeb, DMD
• Maria Degrazia Cohen
• Julie A Deisinger, PH.D.

• Retina Specialist (Ophthalmology) Physician in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Retina Specialist (Ophthalmology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.