Erickson Cruz Bautista, D.N.P

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95002040 Issued in CA

Practice address

6926 Brockton Ave Ste 8
Riverside, CA 92506-3804

Phone

(877) 414-7739

NPI assigned

Jan 31, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altea Medical California PCGroup PAC ID 1850740150, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ericksonbustita@hcpca.allscriptsdirect.net

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Diamond Hospice Services Inc.

  • Community Based Hospice Care Agency
  • Torrance, CA
  • NPI 1609249523

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Legacy Home Health Care, LLC

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1548078249

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

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.

• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• VHC, P.C.

  • Family Medicine Physician
  • Riverside, CA
  • NPI 1306582119
  Medicare reassignment NPD
• Diamond Hospice Services Inc.

  • Community Based Hospice Care Agency
  • Torrance, CA
  • NPI 1609249523
  NPD Authorized official
• Diamond Care Group Inc

  • Community Based Hospice Care Agency
  • Las Vegas, NV
  • NPI 1588233969
  NPD Authorized official
• Legacy Home Health Care, LLC

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1548078249
  NPD (past) Authorized official
• Altea Medical California PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Eureka, CA
  • NPI 1174302954
  Care Compare group
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD

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

{
    "created_epoch": "1422662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1285024083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 CRENSHAW BLVD STE 110",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045078",
            "telephone_number": "310-817-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6926 BROCKTON AVE STE 8",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063804",
            "telephone_number": "877-414-7739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Tropicana Ave Ste 127",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891198313",
            "country_code": "US",
            "telephone_number": "877-505-6828",
            "fax_number": "877-550-3633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "ERICKSON",
        "middle_name": "CRUZ",
        "name_prefix": "Dr.",
        "credential": "D.N.P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-31",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95002040",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "NV",
            "license": "822775",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95002040",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NV",
            "license": "822775",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NV",
            "license": "822775",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95002040",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "715867",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angeles Bautista-Arredondo
• Perla Yanira Bautista-Ponce
• Anthony Oscar Bautista
• Elizabeth Bautista
• Emily Bautista
• Erika Bautista
• Leslie Bautista
• Luis Oscar Bautista, MD
• Marjorie Bautista, DPT
• Rocio Bautista

• Adult Health Nurse Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.