Mary Stephanie Gangcuangco Bautista, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95005578 Issued in CA

Practice address

28062 Baxter Rd
Murrieta, CA 92563-1401

Phone

(956) 534-6114

NPI assigned

May 18, 2016

Last updated

Mar 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside University Health System-Medical Center Hospital, Moreno Valley, CA, CCN 050292

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbautista180400@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment Care Compare group NPD
• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Perris, CA
  • NPI 1891352944
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD

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

• County of Riverside

  • General Acute Care Hospital
  • Moreno Valley, CA
  • NPI 1821159195
  Care Compare affiliation

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1437506581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3853 W STETSON AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925459674",
            "telephone_number": "951-929-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28062 BAXTER RD",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631401",
            "telephone_number": "956-534-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MARY STEPHANIE",
        "middle_name": "GANGCUANGCO",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005578",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "676857",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Basurto
• Arthur Neal Baum
• Jan Bautista
• Jasmine Bautista
• Julianne Bautista
• Nicanor Jebunan Bautista, D.D.S.
• Madison Bayer, SLP-A
• Be Uplifted, a Licensed Professional Clinical Counselor Inc. (Uplifted)
• Dora A Beacham, ACSW
• Sharon Ann Beal Armendariz, MSW, LCSW

• Family Nurse Practitioner in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.