Individual provider Active NPI

Julius Delantar Bautista, DPM

  • Podiatrist
  • Queens Village, NY
National Provider Identifier
1548947625
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
007532 Issued in NY
Practice address
9244 213TH St
Queens Village, NY 11428-1123
Phone
(516) 312-8377
NPI assigned
Jun 30, 2023
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 007532 NY Primary

Addresses

Primary practice location

9244 213TH St
Queens Village, NY 11428-1123

Mailing address

9244 213TH St
Queens Village, NY 11428-1123
Phone (516) 312-8377

Other practice location 1

925 Hempstead Tpke Ste 110
Franklin Square, NY 11010-3636
Phone (516) 352-4454

Other practice location 2

8900 Van Wyck Expy
Jamaica, NY 11418-2897
Phone (718) 206-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260610000614 NY Practitioner - Podiatry 0941771976

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Queens Village, NY 11428
Phone (516) 312-8377

9244 213TH St
Queens Village, NY 11428-1123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P122239NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly Lucas DPM PC PastSince Dec 15, 2019 Accepting new patients
Philip M. Palmeri, DPM, PC Podiatrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1548947625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9244 213TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281123",
            "telephone_number": "516-312-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9244 213TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114281123",
            "telephone_number": "516-312-8377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Hempstead Tpke Ste 110",
            "address_purpose": "LOCATION",
            "city": "Franklin Square",
            "state": "NY",
            "postal_code": "110103636",
            "country_code": "US",
            "telephone_number": "516-352-4454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8900 Van Wyck Expy",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114182897",
            "country_code": "US",
            "telephone_number": "718-206-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "JULIUS",
        "middle_name": "DELANTAR",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-30",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "007532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.