Individual provider Active NPI

Marcus Patrick Bautista, AGACNP-BC

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1346873650
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP145119 Issued in TX
Practice address
6770 Bertner Ave Ste C355
Houston, TX 77030-2604
Phone
(832) 355-3000
NPI assigned
Feb 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP145119 TX Primary
Acute Care Nurse Practitioner 363LA2100X AP145119 TX

Addresses

Primary practice location

6770 Bertner Ave Ste C355
Houston, TX 77030-2604

Mailing address

1 Baylor Plaza Ms:BCM 390
Houston, TX 77030-3411
Phone (832) 355-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20200327002641 TX Practitioner - Nurse Practitioner 6204265119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

7200 Cambridge St
FL 10
Houston, TX 77030-4202
Phone (713) 798-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
33437TXMDPharmacist
AP145119TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Mar 17, 2020 Accepting new patients
Baylor College of Medicine CurrentSince Mar 17, 2020 Accepting new patients
Cardiovascular Care Providers, Inc. PastSince Feb 16, 2020 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

6770 Bertner Ave
Ste C350
Houston, TX 77030
Phone (713) 798-8940

7200 Cambridge St
Fl 10
Houston, TX 77030
Phone 7137981750 ext. 2

6770 Bertner Ave
Ste C355
Houston, TX 77030
Phone (832) 355-3000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1581638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1346873650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLAZA MS:BCM 390",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411",
            "telephone_number": "832-355-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 BERTNER AVE STE C355",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "832-355-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MARCUS",
        "middle_name": "PATRICK",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-14",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP145119",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP145119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.