Individual provider Active NPI

Maria Patricia Bustamante, NP

  • Family Nurse Practitioner
  • Thornton, CO
National Provider Identifier
1851389811
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
92630 Issued in CO
Practice address
8990 N Washington St
Thornton, CO 80229-4537
Phone
(720) 929-1655
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 92630 CO Primary

Addresses

Primary practice location

8990 N Washington St
Thornton, CO 80229-4537

Mailing address

1345 Plaza CT N Ste 1a
Lafayette, CO 80026-2832
Phone (303) 665-3036

Other identifiers 1

IdentifierTypeStateIssuer
10326758MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20070920000799 CO Practitioner - Nurse Practitioner 8820182884 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92630COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Campesina Family Health Services CurrentSince Mar 22, 2016 Accepting new patients
Clinica Campesina Family Health Services CurrentSince Mar 22, 2016 Accepting new patients
Clinica Campesina Family Health Services Current Accepting new patients

Locations

1345 Plaza Ct N
Ste 1A
Lafayette, CO 80026
Phone (303) 665-2962

1735 S Public Rd
Ste 203
Lafayette, CO 80026

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

8990 Washington St
Thornton, CO 80229
Phone (720) 929-1655

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1851389811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 PLAZA CT N STE 1A",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262832",
            "telephone_number": "303-665-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8990 N WASHINGTON ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802294537",
            "telephone_number": "720-929-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "MARIA",
        "middle_name": "PATRICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "92630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10326758",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.