Maria J Bustamante, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV009808-01 Issued in NY

Practice address

1258 6TH Ave
New York, NY 10020-1511

Phone

(503) 705-7755

NPI assigned

Jul 13, 2023

Last updated

Jul 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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 NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maria.bustamante.p1@direct.opt.nextgenshare.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.

• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• State of New York Comptrollers Office

  dba Suny College of Optometry/University Eye Center

  • Optometrist
  • New York, NY
  • NPI 1407829856
  Medicare reassignment NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  NPD
• Empire Vision Center, Inc

  dba Visionworks

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1750060067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201511",
            "telephone_number": "503-705-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "MARIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV009808-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Agustin Busta, MD
• Richard James Bustamante-Quon, L.M.H.C.
• Chris Bustamante, NP-C
• Isabel Marie Bustamante
• Jean Gabriel Bustamante, M.D.
• Patrick Joseph Bustamante, PT
• Reinaldo Eduardo Bustamante, RDH
• Janan Bustami
• Zaid Eyad Bustami
• Maria Bustillo, MD

• Optometrist in New York, NY
• Providers in New York, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.