Mary Vic Amor Mendija Bustillo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20532 Issued in CA

Practice address

1375 Blossom Hill Rd
Suite 49
San Jose, CA 95118-3806

Phone

(408) 646-0261

NPI assigned

Jan 2, 2012

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 CA

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care of California a Medical CorporationGroup PAC ID 5799854303, 135 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24970/brand/1/csg/1/fhir/r4

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.

• American Current Care of California, a Medical Corporation

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1750573622
  Medicare reassignment Care Compare group NPD
• American Current Care of California, a Medical Corporation

  • Urgent Care Clinic/Center
  • Ontario, CA
  • NPI 1811464084
  NPD
• Action Urgent Care Inc

  • Urgent Care Clinic/Center
  • San Jose, CA
  • NPI 1205186442
  NPD (past)

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

{
    "created_epoch": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1851661276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 BLOSSOM HILL RD",
            "address_2": "SUITE 49",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951183806",
            "telephone_number": "408-646-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 BLOSSOM HILL RD",
            "address_2": "SUITE 49",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951183806",
            "telephone_number": "408-646-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTILLO",
        "first_name": "MARY VIC AMOR",
        "middle_name": "MENDIJA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-02",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bose Bustamante, OTR/L
• Gabrielle Bustamante
• Ivana Bustamante
• Bianca Lynn Bustamente, DO
• Connie Bustillo
• Donna Bustos
• Erica Bustos, M.A., BCBA
• Nicole Butac
• Laura Butcher, MD
• Angela Butler, CCC-SLP

• Family Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.

Verify at the official NPI Registry.