MALLORY MARIE BUSTOS
NPI 1912797630
Counselor - Professional in San Antonio, TX
About Mallory Marie Bustos NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALLORY MARIE BUSTOS (NPI 1912797630) is an individual professional provider in San Antonio, Texas, licensed in Texas (92415) and active in the NPI registry since May 2025. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mallory Marie Bustos is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mallory Bustos reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Durham, NC 27701
- Reassigned Medicare billing, Texas enrollment
- 315 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mallory Bustos's NPI number?
The NPI number for Mallory Bustos is 1912797630. It was assigned to this individual provider in the NPPES registry on May 7, 2025.
Where is Mallory Bustos located?
Mallory Bustos practices at 1226 Stable Glen Dr, San Antonio, TX 78245. The listed phone number is (210) 317-9624.
What is Mallory Bustos's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Mallory Bustos enrolled in Medicare?
Yes. Mallory Bustos is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mallory Bustos's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mallory Bustos reassigns Medicare benefits to Mental Health Specialty Group PA (Durham, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mallory Bustos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mallory Bustos accept?
Health plans from Blue Cross and Blue Shield of Texas, Cigna Healthcare and UnitedHealthcare list Mallory Bustos as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mallory Bustos was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mallory Marie Bustos · NPI 1912797630
Professional provider in San Antonio, Texas. Individual provider, active in the CMS NPPES registry since May 7, 2025.
## Identity
- **NPI:** 1912797630 (Entity type: Individual)
- **Enumerated:** May 7, 2025
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 92415 (Texas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1226 STABLE GLEN DR, San Antonio, TX 78245-2969
- **Phone:** (210) 317-9624
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for durable medical equipment
- **Bills Medicare through:** Mental Health Specialty Group PA (NPI 1801472634, Durham, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1912797630) · Data from the CMS NPPES public registry.