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Individual provider Active NPI

Carlos I Bustamante, MD

  • Infectious Disease Physician
  • Aventura, FL
National Provider Identifier
1649216953
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME0059145 Issued in FL
Practice address
20814 W Dixie Highway
Aventura, FL 33180
Phone
(305) 933-8433
Fax
(305) 933-9115
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME0059145 FL Primary

Addresses

Primary practice location

20814 W Dixie Highway
Aventura, FL 33180

Mailing address

20814 W Dixie Highway
Aventura, FL 33180
Phone (305) 933-8433

Other identifiers 1

IdentifierTypeStateIssuer
054309800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110202000137 FL Practitioner - Infectious DiseasePractitioner - Internal Medicine 3476509464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edelstein and Bustamante MDS PAGroup PAC ID 4789630773, 8 clinicians

Practice addresses (Care Compare)

160 NW 170TH St
Miami, FL 33169-5521
Phone (305) 651-1100

1859 Van Buren St
Hollywood, FL 33020-5127
Phone (954) 920-9000

20814 W Dixie Hwy
Aventura, FL 33180-1147
Phone (305) 933-8433

20900 Biscayne Blvd
Aventura, FL 33180-1407
Phone (305) 682-7000

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 987-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0059145FLMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edelstein & Bustamante M.D.'S, P.a. Infectious Disease CurrentSince Oct 1, 1994 Accepting new patients

Locations

20814 W Dixie Hwy
Miami, FL 33180
Phone (305) 918-7076

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1649216953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20814 W DIXIE HIGHWAY",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-933-8433",
            "fax_number": "305-933-9115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20814 W DIXIE HIGHWAY",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-933-8433",
            "fax_number": "305-933-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "CARLOS",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME0059145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054309800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.