Miguel Angel Bautista, CO61191490

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2280 Sr 821
Yakima, WA 98901-1017

Phone

(509) 307-6858

NPI assigned

May 17, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sundown M Ranch

  • Family Medicine Physician
  • Yakima, WA
  • NPI 1285223305
  NPD
• Sundown M Ranch

  • Substance Abuse Rehabilitation Facility
  • Yakima, WA
  • NPI 1154474104
  NPD (past)

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1033856414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 SR 821",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989011017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 SR 821",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989011017",
            "telephone_number": "509-307-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "credential": "CO61191490",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarun Jacob Bathini, M.D.
• Leah Merle Batty-Hibbs, PH.D., LMHC.
• Tyler E Bauer, D.M.D
• Amanda A Baughman, RN
• David E Bauman, PSYD
• Bayan Health Wa PC
• Karina Bayaua
• Guadalupe V Bazan Jr., SUDPT
• BD Yakima I, LLC
• Bridget Beachy, PSYD

• Addiction (Substance Use Disorder) Counselor in Yakima, WA
• Providers in Yakima, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.