Jessie Bautista Pita, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

189860 Issued in NY

Practice address

235 Port Richmond Ave
Staten Island, NY 10302-1701

Phone

(718) 876-1732

Fax

(718) 876-3459

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1023136413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PORT RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021701",
            "telephone_number": "718-876-1732",
            "fax_number": "718-876-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 PORT RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021701",
            "telephone_number": "718-876-1732",
            "fax_number": "718-876-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITA",
        "first_name": "JESSIE",
        "middle_name": "BAUTISTA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "189860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE",
            "identifier": "060630000022",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFINITY",
            "identifier": "000155690012",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01178778",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Ann Marie Pisapia, PT
• Marissa Anne Pisarri-Conti, OTR/L, CHT
• Alessandra Piscina
• Beverly Pisons, RN
• Samantha Victoria Pistek
• Rosemary Pitkin, MD
• Irina Pitsel I
• Matthew A. Pius, MD
• Pivot Point PT PC
• Alexa Pizzarello, RD, CDN

• Pediatrics Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.