Active NPI
Patrick Perez Bautista
- Contractor
- Queens Village, NY
National Provider Identifier
1295869337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 0282451
- Practice address
- 9118 Vanderveer St
Queens Village, NY 11428-1242 - Phone
- (718) 581-9682
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 0282451 | NY | Primary |
Addresses
Primary practice location
9118 Vanderveer St
Queens Village, NY 11428-1242
Mailing address
9118 Vanderveer St
Queens Village, NY 11428-1242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0282451 | NY | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358380800000",
"number": "1295869337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9118 VANDERVEER ST",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114281242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9118 VANDERVEER ST",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114281242",
"telephone_number": "718-581-9682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "PATRICK",
"middle_name": "PEREZ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2013-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NY",
"license": "0282451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queens Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.