Ivar Bustamante Milana, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

29606 Issued in CA

Practice address

29198 Hydrangea St
Murrieta, CA 92563-4419

Phone

(951) 672-0430

Fax

(951) 672-0430

NPI assigned

Feb 8, 2010

Sex

Male

Sole proprietor

Yes

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

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265587200000",
    "number": "1679805188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29198 HYDRANGEA ST",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925634419",
            "telephone_number": "951-672-0430",
            "fax_number": "951-672-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29198 HYDRANGEA ST",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925634419",
            "telephone_number": "951-672-0430",
            "fax_number": "951-672-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANA",
        "first_name": "IVAR",
        "middle_name": "BUSTAMANTE",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Leigh Miedecke
• Yoshinobu Mifune, MD
• Mariana Mihailovici, PTA
• Cynthia R Mila de la Roca
• Milan Massage & Spa Products, LLC
• Jody Lynn Millan
• Miller Optometric Corporation
• Ashley Ann Miller-Deboer, D.C.
• Brandon Walter Miller, PA-C
• Cheryl Miller

• Physical Therapist in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.