NPIMap

Organization Active NPI

Bautista Medical Group

Doing business as Bautista Research Medical Clinic

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1487634317
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BAUTISTA MEDICAL GROUP
Doing business as
Bautista Research Medical Clinic
Practice address
2505 Merced St
Fresno, CA 93721-1811
Phone
(559) 445-0391
Fax
(559) 445-0316
NPI assigned
Jan 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Jose Luis Bautista, MD
Title
Medical Director
Phone
(559) 445-0391

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A43293 CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A84959 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A97270 CA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA16817 CA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA13143 CA

Addresses

Primary practice location

2505 Merced St
Fresno, CA 93721-1811

Mailing address

2505 Merced St
Fresno, CA 93721-1811
Phone (559) 445-0391

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ3862ZOtherCABLUE SHIELD
GR0063040OtherCAMEDI-CAL

Other names 1

  • Bautista Research Medical Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1487634317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MERCED ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211811",
            "telephone_number": "559-445-0391",
            "fax_number": "559-445-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MERCED ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211811",
            "telephone_number": "559-445-0391",
            "fax_number": "559-445-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAUTISTA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "559-445-0391",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A43293",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A84959",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A97270",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16817",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13143",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ3862Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0063040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bautista Research Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.