Individual provider Active NPI

Brian Pablo Bustos, MD

  • Nephrology Physician
  • Washington, DC
National Provider Identifier
1952930455
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD600004069 Issued in DC
Practice address
1140 Varnum St NE Ste 202
Washington, DC 20017-2153
Phone
(202) 269-6430
Fax
(202) 269-6598
NPI assigned
Apr 6, 2020
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 79324 CT
Nephrology Physician 207RN0300X D0103759 MD
Nephrology Physician 207RN0300X MD600004069 DC Primary
Nephrology Physician 207RN0300X 0101286594 VA

Addresses

Primary practice location

1140 Varnum St NE Ste 202
Washington, DC 20017-2153

Mailing address

1140 Varnum St NE Ste 202
Washington, DC 20017-2153
Phone (202) 269-6430

Other practice location 1

6408 Seven Corners Pl Ste C
Falls Church, VA 22044-2011
Phone (202) 269-6430

Other practice location 2

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5011

Other identifiers 2

IdentifierTypeStateIssuer
387742600MedicaidMD
070107673MedicaidDC

Other names 1

  • Dr. Brian Elwin Pablo Bustos Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250212000954 CT Practitioner - Internal Medicine 8628508215 Reassigns benefits to 2 organizations
I20250929000675 DC Practitioner - NephrologyPractitioner - Internal Medicine 8628508215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bustos and AssociatesGroup PAC ID 3274627633, 3 clinicians

Practice addresses (Care Compare)

100 Grand St
New Britain, CT 06052-2016
Phone (860) 224-5121

1140 Varnum St NE PMB
Suite 202
Washington, DC 20017-2151
Phone (202) 269-6430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79324CTMDInternal Medicine Physician
0101286594VAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley Internal Medicine CurrentSince Feb 1, 2025 Accepting new patients
Midstate Medical Center Current Accepting new patients
Midstate Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Midstate Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Doris Pablo-Bustos, MD PC Internal Medicine Current Accepting new patients
Bustos Associates LLC Nephrology CurrentSince Sep 10, 2025 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Feb 1, 2025 Accepting new patients

Locations

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

1140 Varnum St NE
Ste 202
Washington, DC 20017
Phone (202) 269-6430

6408 Seven Corners Pl
Ste C
Falls Church, VA 22044
Phone (703) 237-1197

Interoperability endpoints

  • Direct secure messaging: brian.bustos@xdr.hhchealthdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1952930455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 VARNUM ST NE STE 202",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172153",
            "telephone_number": "202-269-6430",
            "fax_number": "202-269-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 VARNUM ST NE STE 202",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172153",
            "telephone_number": "202-269-6430",
            "fax_number": "202-269-6598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6408 Seven Corners Pl Ste C",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220442011",
            "country_code": "US",
            "telephone_number": "202-269-6430",
            "fax_number": "202-269-6598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Grand St",
            "address_purpose": "LOCATION",
            "city": "New Britain",
            "state": "CT",
            "postal_code": "060522016",
            "country_code": "US",
            "telephone_number": "860-224-5011",
            "fax_number": "860-224-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "BRIAN",
        "middle_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "79324",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": "D0103759",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "DC",
            "license": "MD600004069",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "VA",
            "license": "0101286594",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387742600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070107673",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN ELWIN",
            "last_name": "BUSTOS",
            "middle_name": "PABLO",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.