ABRAHAM VELASCO BUSTAMANTE (PA) – Medical Physician Assistant, NPI 1669293908

ABRAHAM VELASCO BUSTAMANTE (PA) is a healthcare provider. based in Oroville, Washington. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for ABRAHAM VELASCO BUSTAMANTE (PA) is 1669293908

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
ABRAHAM VELASCO BUSTAMANTE (PA)
NPI
1669293908
Phone
(206) 639-5761
Address
90 GOLDEN RD
Enumeration Date
21 October 2024
Last Update Date
11 December 2024

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
5094860114
Graduation Year
2024 (2 years ago)
PAC ID
8628598646
Group Practice PAC ID
9739076217
Professional Enrollment ID
I20250220003484
Address ID
WA988559286TO106XXWHIT300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness75
Years active:1State licenses:0Digital endpointsOther names

4,282 PHYSICIAN ASSISTANT in WA

Provider Addresses for ABRAHAM VELASCO BUSTAMANTE (PA)

  • 90 GOLDEN RD

    OROVILLE, WA 988449766

    Phone: (206) 639-5761

    Type: Mailing

  • 1003 KOALA DR

    OMAK, WA 988419247

    Phone: (800) 660-2129

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250220003484IPhysician AssistantWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98844)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739076217View full group profile
NameSpecialtyState
Internal MedicineWA
Nurse PractitionerWA
Nurse PractitionerWA
Family PracticeWA
-WA
Physician AssistantAZ
Family PracticeWA
Mental Health CounselorWA
General PracticeWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

Can I cross-check ABRAHAM VELASCO BUSTAMANTE (PA) using NPI 1669293908?
NPI 1669293908 belongs to ABRAHAM VELASCO BUSTAMANTE (PA); compare other details if you need extra assurance.
Is ABRAHAM VELASCO BUSTAMANTE (PA) shown as active in public data?
Registry records indicate ABRAHAM VELASCO BUSTAMANTE (PA) maintains an active NPI.
What area of care is associated with ABRAHAM VELASCO BUSTAMANTE (PA)?
ABRAHAM VELASCO BUSTAMANTE (PA)'s record emphasizes Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ABRAHAM VELASCO BUSTAMANTE (PA)?
Travel planning: use Oroville, Washington as the reference point for ABRAHAM VELASCO BUSTAMANTE (PA), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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