Logan Michael Bustos, CRNA

Key facts

NPI: 1942938360
Entity type: Individual (NPI type 1)
Primary specialty: Certified Registered Nurse Anesthetist 367500000X
License: 213377 (OK)
Practice address: 101 S. Parkview St.
Coffeyville, KS 67337
Phone: (620) 252-8766
NPI assigned: Aug 12, 2022
Sex: Male
Sole proprietor: No

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.

Integral Anesthesia, LLC Anesthesiology Physician · Jenks, OK · NPI 1881041515

Medicare reassignment Care Compare group NPD NURSE ANESTHETIST, CERTIFIED REGISTERED · OK
Anesthesia Medical Professionals, PLLC Anesthesiology Physician · Edmond, OK · NPI 1962785931

Medicare reassignment NPD OK
Northstar Anesthesia of Oklahoma, PLLC Anesthesiology Physician · Arlington, TX · NPI 1043516628

Medicare reassignment NPD OK

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

St John Medical Center Inc General Acute Care Hospital · Tulsa, OK · NPI 1154417368

Care Compare affiliation Hospital
St John Medical Center Inc Rehabilitation Hospital Unit · Tulsa, OK · NPI 1578656161

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Certified Registered Nurse Anesthetist (Crna)
Education: Other, 2023
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Integral Anesthesia LLC (159 clinicians)

Practice addresses (Care Compare)

1923 S Utica Ave
Tulsa, OK 74104-6520
Phone (919) 744-3131

Hospital & facility affiliations

Ascension St John Medical Center Hospital · Tulsa, OK · CCN 370114

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OK

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20230713002150	OK	Practitioner - Certified Registered Nurse Anesthetist (Crna)	0840650503	Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD): Yes

Practice roles

Organization	Specialty	Status	New patients
Northstar Anesthesia of Oklahoma, PLLC		Current since Jul 31, 2023	Accepting new patients
Anesthesia Medical Professionals, PLLC		Current since Nov 22, 2023	Accepting new patients
Integral Anesthesia, LLC	Nurse Anesthetist, Certified Registered	Current since May 1, 2025	Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

3029 W Main St
Jenks, OK 74037
Phone (918) 346-5002

5602 SW Lee Blvd
Lawton, OK 73505
Phone (580) 531-4700

12451 E 100th St N
Owasso, OK 74055
Phone (918) 274-5000

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Certified Registered Nurse Anesthetist	367500000X	213377	OK	Yes

Addresses

Primary practice location

101 S. Parkview St.
Coffeyville, KS 67337

Mailing address

101 S. Parkview St.
Coffeyville, KS 67337
Phone (620) 252-8766

Other providers in Coffeyville, KS

All providers in Coffeyville, KS · Certified Registered Nurse Anesthetist in Kansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.