Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Samuel Correa Bustillos, ACNP-AG

Individual provider Acute Care Nurse Practitioner · NPI 1699289173

Samuel Correa Bustillos, ACNP-AG is a Nurse Practitioner in Las Cruces, New Mexico. Qualified in 2017, 9 years ago. Practices with Las Cruces Physician Services LLC, a 103-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
9
Licensed in
NM
In the registry since
2017
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Practice location Address checks out

2450 S Telshor Blvd
Las Cruces, NM 88011-5141
Phone: (575) 636-7407
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence CNP-03431 (NM)

Record details

NPI number1699289173
Entity typeIndividual (Type 1)
GenderMale
Credentials ACNP-AG
Sole proprietorYes
NPI enumeratedNovember 20, 2017
Last updated in NPPESAugust 21, 2023
Certification dateAugust 21, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Las Cruces Physician Services Llc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Las Cruces