NPIMap

Individual provider Active NPI

Teresa Bustamante, NP-C

  • Gerontology Nurse Practitioner
  • Montvale, NJ
National Provider Identifier
1831757939
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00898100 Issued in NJ
Practice address
225 Summit Ave
Montvale, NJ 07645-1523
Phone
(201) 775-7358
NPI assigned
Jun 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00898100 NJ Primary

Addresses

Primary practice location

225 Summit Ave
Montvale, NJ 07645-1523

Mailing address

42 Cherokee Ave
Allendale, NJ 07401-1305
Phone (201) 694-3287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200311000623 NJ Practitioner - Nurse Practitioner 3476981143 Reassigns benefits to 3 organizations
I20240208001808 NY Practitioner - Nurse Practitioner 3476981143 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MSK BergenGroup PAC ID 1456614114, 254 clinicians

Practice addresses (Care Compare)

225 Summit Ave
Montvale, NJ 07645-1523
Phone (908) 542-3336

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

5 N Greenwich Rd
Armonk, NY 10504-2311
Phone (914) 202-0700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
74.7
Improvement activities
40
Cost
69.14

Merit-based Incentive Payment System (MIPS)

Final score
80.37 of 100Reported as group
Quality
71.5
Improvement activities
40
Cost
70.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen County Improvement Authority CurrentSince Apr 26, 2023 Accepting new patients
Bergen County Improvement Authority CurrentSince Apr 26, 2023 Accepting new patients
The Back Pain Center, LLC Gerontology CurrentSince Jan 18, 2023 Accepting new patients
Memorial Neurology Group CurrentSince Dec 18, 2023 Accepting new patients
Proclinix Sports Physical Therapy Chiropractic Wellness,PLLC CurrentSince Nov 1, 2024 Accepting new patients
MSK Harrison CurrentSince Dec 17, 2023 Accepting new patients
MSK Bergen CurrentSince Jan 25, 2020 Accepting new patients
Bergen County Improvement Authority Past Accepting new patients
Bergen County Improvement Authority Past Accepting new patients
Premier Medical of NJ PastSince Jan 18, 2023 Accepting new patients

Locations

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

83 Franklin Tpke
Waldwick, NJ 07463
Phone (201) 444-1079

5 N Greenwich Rd
Armonk, NY 10504
Phone (914) 207-7337

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

500 Westchester Ave
West Harrison, NY 10604
Phone (914) 367-7000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: tbustamante22871@mskcc.direct-ci.com

Organizations & group practices 10

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 7

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1831757939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 CHEROKEE AVE",
            "city": "ALLENDALE",
            "state": "NJ",
            "postal_code": "074011305",
            "telephone_number": "201-694-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SUMMIT AVE",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451523",
            "telephone_number": "201-775-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "TERESA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00898100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montvale, NJ

Sources for this page

Verify at the official NPI Registry.