Mary S Bautista, OTA
Individual provider Active NPI Occupational Therapy Assistant · Homer, AK
NPI 1497639074 · NPPES record last updated Aug 5, 2025
Key facts
- NPI
- 1497639074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 242531 (AK)
- Practice address
- 601 E Pioneer Ave Ste 203
Homer, AK 99603-7694 - Phone
- (907) 435-1907
- NPI assigned
- Aug 5, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242531 | AK | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zank Center, LLC | Past |
Accepting new patients | |
| Changing Tides Therapy Services, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 242531 | AK | Yes |
Addresses
Primary practice location
601 E Pioneer Ave Ste 203
Homer, AK 99603-7694
Mailing address
601 E Pioneer Ave Ste 203
Homer, AK 99603-7694
Phone (907) 435-1071
Other providers in Homer, AK
- Adam Barnett
- Melody A Barrett
- Sherry Bartlett
- Clara Bass
- Sharon Elisa McKemie Bauer
- Joseph Bechtol
- William Harrison Bell
- Kirsti Bendixen
- Elizabeth Benson
- Annamaria Sitenga Bernards
All providers in Homer, AK · Occupational Therapy Assistant in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.