Individual provider Active NPI

Marissa Danielle Bautista, NP

  • Acute Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1619641552
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1046651 Issued in TX
Practice address
6560 Fannin St Ste 1750
Houston, TX 77030-2725
Phone
(713) 790-0400
Fax
(713) 791-2121
NPI assigned
Aug 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1046651 TX Primary

Addresses

Primary practice location

6560 Fannin St Ste 1750
Houston, TX 77030-2725

Mailing address

6560 Fannin St Ste 1750
Houston, TX 77030-2725
Phone (713) 790-0400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012002292 TX Practitioner - Nurse Practitioner 9537567102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Younis Cardiology Associates PLLCGroup PAC ID 7719219104, 5 clinicians

Practice addresses (Care Compare)

6560 Fannin St
Suite 1750
Houston, TX 77030-2725
Phone (713) 790-0400

Hospital & facility affiliations

  • Houston Methodist Hospital Hospital, Houston, TX, CCN 450358

Merit-based Incentive Payment System (MIPS)

Final score
87.61 of 100Reported as group
Quality
88.81
Promoting interoperability
100
Improvement activities
40
Cost
69.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1046651TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Younis Cardiology Associates PLLC CurrentSince Nov 1, 2023 Accepting new patients

Locations

6560 Fannin St
Ste 1750
Houston, TX 77030
Phone (713) 790-0400

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1619641552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 1750",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302725",
            "telephone_number": "713-790-0400",
            "fax_number": "713-791-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 1750",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302725",
            "telephone_number": "713-790-0400",
            "fax_number": "713-791-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MARISSA",
        "middle_name": "DANIELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-04",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1046651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.