Marieta P Bautista, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301040328 Issued in MI

Practice address

35 W Huron St
Pontiac, MI 48342-2120

Phone

(248) 745-4900

Fax

(248) 745-6872

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• CNS Healthcare

  • Psychiatry Physician
  • Novi, MI
  • NPI 1770538068
  NPD (past)
• St. Joseph Mercy Hospital Crna Group

  • Certified Registered Nurse Anesthetist
  • Pontiac, MI
  • NPI 1568493047
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497795298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422120",
            "telephone_number": "248-745-4900",
            "fax_number": "248-745-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422120",
            "telephone_number": "248-745-4900",
            "fax_number": "248-745-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MARIETA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301040328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Basha, M.D.
• Bashar Succar MD PC
• Bashar Yaldo MD PC
• Philip Bates
• Dana Lynn Battaglia
• Sarah Elizabeth Bayley, PARAMEDIC
• Rabei W Bdeir, MD
• Maria Beach, APRN
• Ryan Gordon Beale, MA, TLLP
• Bridget O'Brien Bealin, PA-C

• Psychiatry Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.