Andre Barranda Bautista, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

MD60545139 Issued in WA

Practice address

1304 Fawcett Ave Ste 100
Tacoma, WA 98402-1900

Phone

(253) 761-4200

NPI assigned

Apr 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Diagnostic RadiologyAlso: Interventional Radiology

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tra-Minw P SGroup PAC ID 2163316167, 152 clinicians

Medical Imaging Northwest - Good Samaritan Hospital Imaging AllianceGroup PAC ID 3375603970, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
• St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
• St Clare Hospital Hospital, Lakewood, WA, CCN 500021
• St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ei-trami

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.

• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1083802946
  Medicare reassignment Care Compare group NPD
• Tra-Minw P S

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1396814166

  OR

  Medicare reassignment Care Compare group NPD
• Tra Medical Imaging Centers LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1447041751
  Medicare reassignment NPD
• Union Avenue Open MRI LLC

  • Radiology Clinic/Center
  • Tacoma, WA
  • NPI 1568531242
  Medicare reassignment NPD
• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Puyallup, WA
  • NPI 1336419514
  NPD
• Tra-Minw P S

  • Radiology Clinic/Center
  • Federal Way, WA
  • NPI 1184790032
  NPD
• Tra-Minw, PS

  • Diagnostic Radiology Physician
  • Pendleton, OR
  • NPI 1588904338
  NPD
• Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance

  • Radiology Clinic/Center
  • Bonney Lake, WA
  • NPI 1760636930
  NPD (past)

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

• Franciscan Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1124291117
  Care Compare affiliation
• Franciscan Health System

  • General Acute Care Hospital
  • Gig Harbor, WA
  • NPI 1447406699
  Care Compare affiliation
• Franciscan Health System

  • Clinical Medical Laboratory
  • Tacoma, WA
  • NPI 1659585370

  Hospital

  Care Compare affiliation
• Franciscan Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1952309098
  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation
• Multicare Health System

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation
• Saint Clare Hospital

  • Clinical Medical Laboratory
  • Lakewood, WA
  • NPI 1003029745

  Hospital

  Care Compare affiliation
• Saint Clare Hospital

  • General Acute Care Hospital
  • Lakewood, WA
  • NPI 1689672693
  Care Compare affiliation

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1164665444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984021900",
            "telephone_number": "253-761-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "ANDRE",
        "middle_name": "BARRANDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-15",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60545139",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD60545139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2044117",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Sue Baumgartner
• Lawrence Robert Bauml, DC
• Stephen Joseph Bauml, DC
• Sara Baur
• Anastasia Sauve Bautista, RN
• Bethel Joy Bautista Bautista
• Jazel Jane Manongdo Bautista, RPH
• Wilbur Domenden Bautista
• Amber J Baxter, ARNP NNP-BC
• Jennifer Baxter, AAHCC

• Vascular & Interventional Radiology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Vascular & Interventional Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.