Saul Javier Bautista, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

320049 Issued in NY

Practice address

701 Grove Rd
Greenville, SC 29605-4210

Phone

(864) 455-7844

Fax

(864) 455-7848

NPI assigned

Jun 13, 2019

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1497315394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-7844",
            "fax_number": "864-455-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054210",
            "telephone_number": "864-455-7844",
            "fax_number": "864-455-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "SAUL",
        "middle_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL82813",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "320049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randall Baughman, OD
• Thomas Baumgarten, M D
• Lisa Baumhofer, MS, CCC-SLP
• Jack H Baur Jr., D.D.S.
• Jacquelyn Baur, OTR/L
• Hareshchandra Baxi, MD
• Hannah Brooke Baxley
• Jacob Xavier Baxter, MD
• Bay Laurel Center, Inc
• Bayada Home Health Care, Inc.

• All providers in Greenville, SC
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.

Verify at the official NPI Registry.