Melissa Alejandra Zegarra Bustamante, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME150504 Issued in FL

Practice address

1975 S John Young Pkwy Ste 204
Kissimmee, FL 34741-0603

Phone

(407) 249-1234

NPI assigned

Jul 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saltzman, Tanis, Pittell, Levin and Jacobson

  dba Pediatric Associates

  • Pediatrics Physician
  • Hollywood, FL
  • NPI 1639138480
  NPD (past)

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1912485327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11513 LAKE UNDERHILL RD STE 220",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255001",
            "telephone_number": "407-249-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 S JOHN YOUNG PKWY STE 204",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410603",
            "telephone_number": "407-249-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEGARRA BUSTAMANTE",
        "first_name": "MELISSA",
        "middle_name": "ALEJANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME150504",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110588000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Vincent Zauss, LMHC
• Maria Fernanda Zavala Malla
• Shin Zaw
• Carlos Roberto Zayas Torres, M.D.
• Diana Ivone Zayas, MSW
• Jamie Beth Zehren
• Zenith Women's Health LLC
• Imelda Zepeda
• Annique Zephirin, RBT
• Doris Josefina Zerpa

• Pediatrics Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.