Individual provider Active NPI

George C Bobustuc, MD

  • Neurology Physician
  • Austin, TX
National Provider Identifier
1790760676
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036107297 Issued in IL
Practice address
2600 E Martin Luther King Jr Blvd
Austin, TX 78702-1449
Phone
(512) 505-5500
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 56643 WI
Neurology Physician 2084N0400X 56643 WI
Neurology Physician 2084N0400X K8716 TX
Neurology Physician 2084N0400X 036107297 IL Primary

Addresses

Primary practice location

2600 E Martin Luther King Jr Blvd
Austin, TX 78702-1449

Mailing address

9715 Burnet Rd BLDG 7
Ste.200
Austin, TX 78758-5215
Phone (512) 505-5500

Other practice location 1

2650 Ridge Ave
Evanston, IL 60201-1700
Phone (847) 570-2112

Other identifiers 1

IdentifierTypeStateIssuer
271397700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201104001000 TX Practitioner - Neurology 0941244610 Reassigns benefits to 1 organization
I20220603001990 IL Practitioner - Neurology 0941244610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

800 W Central Rd
Arlington Heights, IL 60005-2349
Phone (847) 618-1000

Hospital & facility affiliations

  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036107297ILMDNeurology Physician
K8716TXMDNeurology Physician
56643WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Medical Specialists, PLLC CurrentSince Oct 20, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince May 19, 2022 Accepting new patients
Central Texas Medical Specialists PLLC Medical Oncology CurrentSince Oct 20, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince May 19, 2022 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2600 E Mlk Blvd
Austin, TX 78702
Phone (512) 334-2600

1400 N Interstate 35
Austin, TX 78701
Phone (512) 324-8565

9715 Burnet Rd
Ste 200
Austin, TX 78758
Phone (512) 334-2866

3201 S Austin Ave
Ste 315
Georgetown, TX 78626
Phone (512) 302-1210

Interoperability endpoints

  • Direct secure messaging: gbobustuc43159@direct.myadvocateaurora.org
  • Direct secure messaging: gbobustuc148971@direct.nch.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1790760676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9715 BURNET RD BLDG 7",
            "address_2": "STE.200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585215",
            "telephone_number": "512-505-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E MARTIN LUTHER KING JR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787021449",
            "telephone_number": "512-505-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011700",
            "country_code": "US",
            "telephone_number": "847-570-2112",
            "fax_number": "847-570-1041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBUSTUC",
        "first_name": "GEORGE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WI",
            "license": "56643",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "56643",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "K8716",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036107297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271397700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.