Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ELIZABETH MARY BUSTAMANTE MD
NPI 1952096679
Internal Medicine in Kentwood, MI

Q: What is Elizabeth Bustamante's NPI number?

The NPI number for Elizabeth Bustamante is 1952096679. It was assigned to this individual provider in the NPPES registry on April 7, 2023.

Q: What is Elizabeth Bustamante's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since April 07, 2023PECOS Enrolled

4444 KALAMAZOO AVE SE STE 200, KENTWOOD, MI 49508(616) 391-5600 Get Directions Write a Review

NPPES record last updated: September 2, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 2, 2026, Feb 6, 2025, Jun 22, 2023 and 1 more (4 updates tracked since 2023).

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About Elizabeth Mary Bustamante Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH MARY BUSTAMANTE MD (NPI 1952096679) is an individual internal medicine provider in Kentwood, Michigan, licensed in Michigan (4351051300) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and is a graduate of Wayne State University School Of Medicine (2023).

NPPES Registry Identity

NPI1952096679

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameELIZABETH MARY BUSTAMANTECredential: MD

Location Address4444 KALAMAZOO AVE SE STE 200Kentwood, MI 49508-4600

Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560

Phone(616) 391-5600

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 2023

Enumeration DateApril 7, 2023

Last NPPES UpdateSeptember 2, 20264 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2026

✔ NPI 1952096679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MI · 4351051300

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

4444 KALAMAZOO AVE SE STE 200, Kentwood, MI 49508

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Mary Bustamante Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698133155

PECOS Enrollment IDI20260729001799

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49508 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMBER PAIGE GALL NP

Nurse Practitioner

4444 KALAMAZOO AVE SE STE 200
KENTWOOD, MI 49508

Kent County (616) 391-5600

KELSIE ANNE FIRN PA

Physician Assistant

4444 KALAMAZOO AVE SE STE 200
KENTWOOD, MI 49508

Kent County (616) 391-5600

MARGARET ELLEN LOVE MD

Internal Medicine

4444 KALAMAZOO AVE SE STE 200
GRAND RAPIDS, MI 49508

Kent County (616) 391-5600

PRAGYAN PATRO MD

Internal Medicine

4444 KALAMAZOO AVE SE STE 200
KENTWOOD, MI 49508

Kent County (616) 391-5600

KRYSTAL JILL AUERNHAMER PA

Physician Assistant (Medical)

4444 KALAMAZOO AVE SE STE 200
KENTWOOD, MI 49508

Kent County (616) 391-5600

JENNIFER KAY BARONE FNP

Nurse Practitioner (Family)

4444 KALAMAZOO AVE SE STE 200
KENTWOOD, MI 49508

Kent County (616) 391-5600

BRIAN THOMAS GAVIN MD

Internal Medicine

4444 KALAMAZOO AVE SE STE 200
GRAND RAPIDS, MI 49508

Kent County (616) 391-5600

DEREK OLSON DO

Internal Medicine

4444 KALAMAZOO AVE SE STE 200
KENTWOOD, MI 49508

Kent County (616) 391-5600

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 Elizabeth Bustamante's NPI number?

The NPI number for Elizabeth Bustamante is 1952096679. It was assigned to this individual provider in the NPPES registry on April 7, 2023.

Where is Elizabeth Bustamante located?

Elizabeth Bustamante practices at 4444 Kalamazoo Ave SE Ste 200, Kentwood, MI 49508. The listed phone number is (616) 391-5600.

What is Elizabeth Bustamante's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Elizabeth Bustamante enrolled in Medicare?

Yes. Elizabeth Bustamante is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Elizabeth Bustamante was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.