Individual provider Active NPI

Alice C Bustos, MD

  • Family Medicine Physician
  • West Allis, WI
National Provider Identifier
1861440505
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34039-020 Issued in WI
Practice address
7220 W National Ave
West Allis, WI 53214-4734
Phone
(414) 257-8500
Fax
(414) 257-8505
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 34039-020 WI
Family Medicine Physician 207Q00000X 34039-020 WI Primary

Addresses

Primary practice location

7220 W National Ave
West Allis, WI 53214-4734

Mailing address

7220 W National Ave
West Allis, WI 53214-4734
Phone (414) 257-8500

Other identifiers 1

IdentifierTypeStateIssuer
32058200MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address abustos23322@direct.myadvocateaurora.org Direct
Other URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040622001304 WI Practitioner - Family Practice 8426033580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

6609 W Greenfield Ave
West Allis, WI 53214-4958
Phone (414) 257-8500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
34039-020WIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2004 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Apr 1, 2004 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

7080 N Port Washington Rd
Glendale, WI 53217
Phone (414) 228-4940

1575 N Rivercenter Dr
Milwaukee, WI 53212
Phone (414) 283-8444

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2801 S Moorland Rd
New Berlin, WI 53151
Phone (262) 860-7800

915 Summit Ave
Summit, WI 53066
Phone (262) 569-2300

620 15th Ave
Union Grove, WI 53182
Phone (262) 878-1211

6609 W Greenfield Ave
West Allis, WI 53214
Phone (414) 257-8500

2424 S 90th St
Ste 310
West Allis, WI 53227
Phone (414) 328-8700

7220 W National Ave
West Allis, WI 53214
Phone (414) 257-8500

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 5

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1861440505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7220 W NATIONAL AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144734",
            "telephone_number": "414-257-8500",
            "fax_number": "414-257-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 W NATIONAL AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532144734",
            "telephone_number": "414-257-8500",
            "fax_number": "414-257-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "ALICE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "34039-020",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "34039-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32058200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abustos23322@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7220 W National Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7220 W National Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532144734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.