Freddie Bautista

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15087100 Issued in NJ

Practice address

220 W Jersey St Apt 1B
Elizabeth, NJ 07202-1314

Phone

(908) 230-8785

NPI assigned

Jul 31, 2024

Last updated

Jul 31, 2024By the provider in NPPES

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

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barnabas Health Medical Group, PCGroup PAC ID 0648172809, 257 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1134129802
  Care Compare affiliation
• Trinitas Regional Medical Center

  dba Trinitas Hospital Medical Oncologists

  • Specialist
  • Elizabeth, NJ
  • NPI 1487697785

  Hospital

  Care Compare affiliation
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1770583999
  Care Compare affiliation
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1790785913
  Care Compare affiliation

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1124857826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W JERSEY ST APT 1B",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021314",
            "telephone_number": "908-230-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W JERSEY ST APT 1B",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021314",
            "telephone_number": "908-230-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "FREDDIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15087100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlos Antonio Barragan, D.D.S.
• Kristie M Barthelemy, MA
• Sergey Yevgenyevich Basin, D.D.S.
• Ankita Bassi, MD
• Sanjay Batta, M.D
• Zlata G Bavli
• Jacqueline Baxley, MS, LPC, ACS
• Bayada Home Health Care, Inc.
• Bayada Home Health Care, Inc.
• Bayonne Ortho Fitting LLC

• Psychiatric/Mental Health Nurse Practitioner in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.