Carlos Bautista, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

243704-1 Issued in NY

Practice address

777 N Raymond St
Boise, ID 83704-9251

Phone

(208) 514-2500

Fax

(208) 375-2217

NPI assigned

Jul 11, 2011

Last updated

Jul 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reno Sparks Indian ColonyGroup PAC ID 6507761897, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mission Home Health of Carson City Home health agency, Carson City, NV, CCN 297249
• Renown Regional Medical Center Hospital, Reno, NV, CCN 290001
• Renown South Meadows Medical Center Hospital, Reno, NV, CCN 290049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: carlos.bautista.p1@direct.rsthc.nextgenshare.com

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.

• Reno Sparks Indian Colony

  dba reno sparks tribal health center

  • Clinic/Center
  • Reno, NV
  • NPI 1497700801

  TX

  Medicare reassignment Care Compare group
• Spirit Lake Tribe

  dba Spirit Lake Health Center

  • Health Service Clinic/Center
  • Fort Totten, ND
  • NPI 1114472891
  NPD (past)

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

• Healthy Living at Home - Carson City LLC

  • Home Health Agency
  • Carson City, NV
  • NPI 1922597574
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  Care Compare affiliation
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1932517299
  Care Compare affiliation
• Renown South Meadows Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1720058027
  Care Compare affiliation

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1134417272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N RAYMOND ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049251",
            "telephone_number": "208-514-2500",
            "fax_number": "208-375-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "243704-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Joseph Baures, M.D.
• Ashlee Bauter, N.P.
• Jonathan W Bauter, DDS
• Anthony Bautista, LMT, CPT, CES
• Brandon Robert Bautista
• Lesena Bautista
• Daniel Bawcom, RN
• Jamie Lou Baxter
• Jenessa Lynn Baxter, SLP-3375
• Norma Sue Spring Baxter, LCSW

• Family Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.