Samuel Correa Bustillos, ACNP-AG

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

CNP-03431 Issued in NM

Practice address

2450 S Telshor Blvd
Las Cruces, NM 88011-5141

Phone

(575) 636-7407

NPI assigned

Nov 20, 2017

Last updated

Aug 21, 2023By the provider in NPPES

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

Other names 1

• Samuel Correa Bustillos Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Las Cruces Physician Services LLCGroup PAC ID 8224122759, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Regional Medical Center Hospital, Las Cruces, NM, CCN 320085

Merit-based Incentive Payment System (MIPS)

Final score

89.53 of 100Reported as apm

Quality

79.07

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.bustillos.1@1928.direct.athenahealth.com

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.

• Las Cruces Physician Services LLC

  • Orthopaedic Surgery Physician
  • Las Cruces, NM
  • NPI 1215079678
  Medicare reassignment Care Compare group NPD
• Las Cruces HB Medical Services LLC

  dba MountainView Regional Medical Center

  • Emergency Medicine Physician
  • Las Cruces, NM
  • NPI 1598446171

  Nurse Practitioner

  Medicare reassignment NPD
• Las Cruces Physician Practices, LLC

  dba NM Cardiovascualr Associates

  • Vascular Surgery Physician
  • Las Cruces, NM
  • NPI 1093947491
  Medicare reassignment NPD
• Southwest Emergency Medical Associates of NM PC

  • Emergency Medicine Physician
  • Las Cruces, NM
  • NPI 1720505571

  Nurse Practitioner

  Medicare reassignment NPD
• Las Cruces Physician Practices, LLC

  dba New Mexico Cardiac Care

  • Cardiovascular Disease Physician
  • Las Cruces, NM
  • NPI 1346586195
  NPD
• Familycare Associates,PA

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1821161407
  NPD (past)

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

• Las Cruces Medical Center LLC

  dba Mountainview Regional Medical Center

  • General Acute Care Hospital
  • Las Cruces, NM
  • NPI 1205882503
  Care Compare affiliation

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1699289173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 S VALLEY DR STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053165",
            "telephone_number": "575-526-7777",
            "fax_number": "575-647-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115141",
            "telephone_number": "575-636-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTILLOS",
        "first_name": "SAMUEL",
        "middle_name": "CORREA",
        "credential": "ACNP-AG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-20",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "CNP-03431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samuel.bustillos.1@1928.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "AMR direct address",
            "affiliationName": "Las Cruces Medical Center LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1455 S Valley Dr Ste A",
            "city": "Las Cruces",
            "state": "NM",
            "country_code": "US",
            "postal_code": "880053165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMUEL",
            "last_name": "BUSTILLOS",
            "middle_name": "CORREA",
            "credential": "FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Carlos Bustamante
• Jennica Bustamante
• Manuel A. Bustamante
• Noemi Correa Bustillos, COTA/L
• Samantha Lyn Bustillos, NURSE PRACTITIONER
• Briana Radosevich Bustos, CCC-SLP
• Busy Bee Psychological Services Inc
• Ashley J Butler IV, MCJ, MPA
• Karen Marie Butler
• Stephanie Cuellar Butler

• Acute Care Nurse Practitioner in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Acute Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.