Leody Caibigan Bautista, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Tupelo, MS
NPI 1427286236 · NPPES record last updated Oct 25, 2013
Key facts
- NPI
- 1427286236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 22101 (MS)
- Practice address
- 606 Brunson Dr
Tupelo, MS 38801-4947 - Phone
- (662) 840-4010
- Fax
- (662) 840-9038
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Obstetrics and Gynecology PC
Practice addresses (Care Compare)
726 Coulter Dr
New Albany, MS 38652-2807
Phone (662) 534-4121
Hospital & facility affiliations
- Baptist Memorial Hospital Union County
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130819000305 | MS | Practitioner - Obstetrics/Gynecology | 0042452229 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Obhg Mississippi, P.C. | Obstetrics & Gynecology | Current |
Accepting new patients |
| Advanced Obstetrics & Gynecology PC | Current |
Accepting new patients | |
| Heritage Obstetrics & Gynecolgy Clinic of NM PA | Past | Accepting new patients | |
| Baptist Memorial Hospital Union County, Inc. | Past | Accepting new patients |
Locations
1225 N State St
Jackson, MS 39202
Phone (601) 292-4261
200 State Highway 30 W
New Albany, MS 38652
Phone (601) 534-7631
726 Coulter Dr
New Albany, MS 38652
Phone (662) 316-1908
10 Centimeters Dr
Mauldin, SC 29662
Phone (800) 867-2289
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 22101 | MS | Yes |
Addresses
Primary practice location
606 Brunson Dr
Tupelo, MS 38801-4947
Mailing address
606 Brunson Dr
Tupelo, MS 38801-4947
Phone (662) 840-4010
Other providers in Tupelo, MS
- Bonnie N. Basler
- Teresa R Bass
- Lara Bataineh
- Shannon Bates
- Sonya R Bates
- Jenni Baxter
- Be Hope, LLC
- Myesha Bean
- Mylie Kate Beane
- Kwadis James Beard
All providers in Tupelo, MS · Obstetrics & Gynecology Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.