Active NPI
Carlos Andres Bustamante, M.D.
- Surgery Physician
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME145471
- Practice address
- 8380 Riverwalk Park Blvd Ste 100
Fort Myers, FL 33919-8758 - Phone
- (239) 343-9960
- Fax
- (239) 343-9977
- NPI assigned
- Apr 8, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME145471 | FL | Primary |
Addresses
Primary practice location
8380 Riverwalk Park Blvd Ste 100
Fort Myers, FL 33919-8758
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9960
Other practice location 1
6201 Alliance Ln Ste 200
Fort Myers, FL 33912-7165
Phone (239) 343-9960
Other practice location 2
6201 Alliance Ln Ste 100
Fort Myers, FL 33912-7164
Phone (239) 343-2052
Other practice location 3
17 Davis Blvd
suite 308
Tampa, FL 33606-3475
Phone (813) 259-8510
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107405600 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cbustamante246146@Direct.leememorial.org | Lee Memorial Health System |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Virginia School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900
2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000
3227 Lee Blvd
Suite F
Lehigh Acres, FL 33971-1428
Phone (239) 368-0028
8380 Riverwalk Park Blvd
Suite 100
Fort Myers, FL 33919-8758
Phone (239) 343-9960
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Hospital & facility affiliations
- Lee Memorial Hospital
- Cape Coral Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700
8380 Riverwalk Park Blvd
Ste 100
Fort Myers, FL 33919
Phone (239) 343-9960
6201 Alliance Ln
Ste 100
Fort Myers, FL 33912
Phone (239) 343-1176
6201 Alliance Ln
Ste 200
Fort Myers, FL 33912
Phone (239) 343-1176
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- cbustamante246146@direct.leememorial.org
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1992873319
-
- Ambulatory Surgical Clinic/Center
- Fort Myers, FL
- NPI 1720823701
-
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
- Federally Qualified Health Center (FQHC)
- Port Charlotte, FL
- NPI 1255171765
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1427806025
-
- General Acute Care Hospital
- Cape Coral, FL
- NPI 1780429076
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775779200000",
"number": "1821484619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-343-9960",
"fax_number": "239-343-9977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8380 RIVERWALK PARK BLVD STE 100",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339198758",
"telephone_number": "239-343-9960",
"fax_number": "239-343-9977"
}
],
"practiceLocations": [
{
"address_1": "6201 Alliance Ln Ste 200",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339127165",
"country_code": "US",
"telephone_number": "239-343-9960",
"fax_number": "239-343-9977",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6201 Alliance Ln Ste 100",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339127164",
"country_code": "US",
"telephone_number": "239-343-2052",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "17 Davis Blvd",
"address_2": "suite 308",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336063475",
"country_code": "US",
"telephone_number": "813-259-8510",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUSTAMANTE",
"first_name": "CARLOS",
"middle_name": "ANDRES",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-08",
"last_updated": "2026-04-10",
"certification_date": "2026-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME145471",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "107405600",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cbustamante246146@Direct.leememorial.org",
"affiliation": "Y",
"affiliationName": "Lee Memorial Health System",
"address_1": "2776 Cleveland Ave",
"city": "Fort Myers",
"state": "FL",
"country_code": "US",
"postal_code": "339015864",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; 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.