Michelle Martha Bautista, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.011952 Issued in IL

Practice address

917 W 18TH St Ste 219
Chicago, IL 60608-2400

Phone

(773) 480-3412

NPI assigned

May 29, 2007

Sex

Female

Sole proprietor

Yes

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment Care Compare group NPD
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Medicare reassignment NPD
• Tagua Counseling PLLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1285348912
  NPD Authorized official
• Rush University Medical Center

  • Clinic/Center
  • Chicago, IL
  • NPI 1356891618
  NPD
• Rush Health and Aging

  • Social Worker
  • Chicago, IL
  • NPI 1215246269
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1346441250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12454",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606120454",
            "telephone_number": "773-480-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W 18TH ST STE 219",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082400",
            "telephone_number": "773-480-3412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 S Paulina St # 438",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123808",
            "country_code": "US",
            "telephone_number": "312-942-9888",
            "fax_number": "312-942-6116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MICHELLE",
        "middle_name": "MARTHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Lim Bautista, OTR
• Erleine Bautista, MD
• Jessica Noelle O Bautista, DPT
• Kristine L Bautista
• Maria Riza De Guzman Bautista, MD
• Miguel Bautista, CADC
• Joseph Bradley Bavaro, MD
• Joanne Sim Bavelis, PAC
• Margaret Bavis
• Aakash Bavishi, MD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.