Individual provider Active NPI

Amy M Bustin, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1982643920
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051630 Issued in PA
Practice address
1015 Chestnut St
Suite 821
Philadelphia, PA 19107-4316
Phone
(215) 922-1801
Fax
(215) 922-1806
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051630 PA Primary

Addresses

Primary practice location

1015 Chestnut St
Suite 821
Philadelphia, PA 19107-4316

Mailing address

1015 Chestnut St
Suite 821
Philadelphia, PA 19107-4316
Phone (215) 922-1801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20040629000612 PA Practitioner - Physician Assistant 4981680915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynnewood, PA 19096-3432

100 E Lancaster Ave
Wynewood, PA 19096-3450

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chester County Orthopaedic Associates,LTD Past Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients

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.

Hospital & facility affiliations 6

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1982643920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST",
            "address_2": "SUITE 821",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074316",
            "telephone_number": "215-922-1801",
            "fax_number": "215-922-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST",
            "address_2": "SUITE 821",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074316",
            "telephone_number": "215-922-1801",
            "fax_number": "215-922-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTIN",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.