Jeffrey Bautista, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-5283 Issued in HI

Practice address

1001 Kamokila Blvd Ste 114
Kapolei, HI 96707-2095

Phone

(808) 674-0500

NPI assigned

Oct 4, 2021

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 HI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Stayfit Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Aiea, HI
  • NPI 1740488006
  Medicare reassignment NPD

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1235801531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-1075 KAUNOLU ST",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062852",
            "telephone_number": "808-259-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 KAMOKILA BLVD STE 114",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072095",
            "telephone_number": "808-674-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Barrack, MD
• Gerard Barrack
• Evangeline Cabagay Bartolome
• Michelle Ann Bastardo
• Barry Elliott Batts Jr.
• Victoria Aimee Bautista
• Karen Sue Bayard, LCSW QCSW
• Ofelia Bayless
• Sarah Bear
• Mana Grace Beck

• Physical Therapist in Kapolei, HI
• Providers in Kapolei, HI by specialty
• Physical Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.