Ben Jay Bautista
Individual provider Active NPI Acute Care Nurse Practitioner · Jersey City, NJ
NPI 1427728864 · NPPES record last updated Sep 16, 2021
Key facts
- NPI
- 1427728864
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 26NJ01186000 (NJ)
- Practice address
- 355 Grand St
Jersey City, NJ 07302-4321 - Phone
- (201) 915-2000
- NPI assigned
- Sep 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240823002787 | NJ | Practitioner - Nurse Practitioner | 2466824164 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group PC | Current |
Accepting new patients | |
| Barnabas Health Medical Group PC | Current |
Accepting new patients |
Locations
355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224
475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000
94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 26NJ01186000 | NJ | Yes |
Addresses
Primary practice location
355 Grand St
Jersey City, NJ 07302-4321
Mailing address
76 Grieco Dr
Jersey City, NJ 07305-4898
Phone (201) 467-6970
Other providers in Jersey City, NJ
- Kristyn Batta
- Elizabeth M Battiston
- Ronald Battiston I
- Ruchika Batwara
- Cordelia Baum
- Bayada Home Health Care, Inc.
- Bayada Home Health Care, Inc.
- Bayfront Medical Associates, LLC
- Jigger John Baylon
- Dulce Corazon Mendoza Bayot
All providers in Jersey City, NJ · Acute Care Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2021. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.