Active NPI
Betalina Blanco Bumatay, M.D.
- Pediatrics Physician
- Manteca, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A50060
- Practice address
- 165 Saint Dominics Dr Ste 201
Manteca, CA 95337-7802 - Phone
- (209) 823-2345
- NPI assigned
- Apr 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A50060 | CA | Primary |
Addresses
Primary practice location
165 Saint Dominics Dr Ste 201
Manteca, CA 95337-7802
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A50060 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Choice Physician Partners | Pediatrics | Current | Accepting new patients |
| First Choice Physician Partners | Current | Accepting new patients | |
| First Choice Physician Partners | Current | Accepting new patients | |
| Sutter Valley Medical Foundation | Pediatrics | Current | Accepting new patients |
| Sutter Valley Medical Foundation | Current | Accepting new patients | |
| Sutter Valley Medical Foundation | Pediatrics | Current | Accepting new patients |
| Sutter North Medical Foundation | Past | Accepting new patients |
Locations
2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731
815 Court St
Ste 7
Jackson, CA 95642
Phone (209) 257-5900
1300 W Lodi Ave
Ste P
Lodi, CA 95242
Phone (209) 366-1990
1262 E North St
Manteca, CA 95336
Phone (209) 823-7646
1026 Lifestyle St
Manteca, CA 95337
Phone (209) 823-2345
165 Saint Dominics Dr
Ste 201
Manteca, CA 95337
Phone (209) 239-0120
1234 E North St
Ste 103
Manteca, CA 95336
Phone (209) 647-3101
600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755
2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850
Interoperability endpoints
- bblancobumatay264637@hisp.ehr.sutterhealth.org
- betalina.bumatay@843.chartlogic.direct-ci.com
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
Pediatrics
-
- Neurological Surgery Physician
- Modesto, CA
- NPI 1104183052
-
- Ophthalmology Physician
- El Monte, CA
- NPI 1912732892
-
- Durable Medical Equipment & Medical Supplies
- Tracy, CA
- NPI 1720930712
-
- Multi-Specialty Clinic/Center
- Sacramento, CA
- NPI 1952327256
Pediatrics
-
- Ambulatory Surgical Clinic/Center
- Yuba City, CA
- NPI 1144251521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708387200000",
"number": "1477510097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 255228",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958655228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 SAINT DOMINICS DR STE 201",
"city": "MANTECA",
"state": "CA",
"postal_code": "953377802",
"telephone_number": "209-823-2345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUMATAY",
"first_name": "BETALINA",
"middle_name": "BLANCO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-27",
"last_updated": "2024-02-20",
"certification_date": "2024-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A50060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manteca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.