Jose R. Bustillo, D.O

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MB09447600 Issued in NJ

Practice address

201 Lyons Ave
Newark, NJ 07112-2027

Phone

(973) 926-7000

NPI assigned

Aug 22, 2014

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 NJ

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

Internal MedicineAlso: Pediatric Medicine

Education

Ohio University, College of Osteopathic Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Cov Clinic NJ LLCGroup PAC ID 7810303773, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002
• The University Hospital Hospital, Newark, NJ, CCN 310119

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbustillo229313@epicdirect.rwjbh.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.

• Rwjbh Primary Care Services

  • Internal Medicine Physician
  • West Orange, NJ
  • NPI 1265037501

  Internal Medicine, NJ

  Medicare reassignment Care Compare group NPD
• Cov Clinic NJ LLC

  • Internal Medicine Physician
  • Tinton Falls, NJ
  • NPI 1578157962

  NJ

  Medicare reassignment Care Compare group
• Rwjbh Observation Associates LLC

  • Emergency Medicine Physician
  • Livingston, NJ
  • NPI 1760095806

  Internal Medicine, NJ

  Medicare reassignment NPD
• University Physician Associates of New Jersey Inc

  • Pediatrics Physician
  • Newark, NJ
  • NPI 1679583272

  NJ, Pediatrics

  Medicare reassignment NPD
• University Physician Associates of New Jersey Inc

  • Internal Medicine Physician
  • Newark, NJ
  • NPI 1760492367

  Internal Medicine

  NPD
• Newark Beth Israel Medical Center Inc

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966
  NPD (past)

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

• Newark Beth Israel Medical Center Inc

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966

  Hospital

  Care Compare affiliation
• University Hospital

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215998323

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1679972947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2414 EDWARD STEC BLVD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088377008",
            "telephone_number": "908-451-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTILLO",
        "first_name": "JOSE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB09447600",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB09447600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse J Burrini Jr., D.C.
• Amanda Theresa Bursese, DPT
• Tashia R Burton, LPC
• Jeannine Burzynski, LPC
• Mathew Bushey
• Morgan Busumtwi, PTA
• Amish Butala
• Angie Buttigieg
• Joseph Buttler
• C-Neta Behavioral Health Services LLC

• All providers in Newark, NJ
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.