Irene H Bautista, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35048439B Issued in OH

Practice address

17951 Jefferson Park Rd
Cleveland, OH 44130-8439

Phone

(440) 816-6414

Fax

(440) 816-6421

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• University Primary Care Practices Inc.

  • Durable Medical Equipment & Medical Supplies
  • Mentor, OH
  • NPI 1053405217
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1659311660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18181 PEARL RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366949",
            "telephone_number": "440-816-6414",
            "fax_number": "440-816-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17951 JEFFERSON PARK RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441308439",
            "telephone_number": "440-816-6414",
            "fax_number": "440-816-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "IRENE",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35048439B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0507624",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy L Baumgartner, CNP
• Dale A. Baur, DDS
• Thomas John Bauriedel, QMHS MA CMS MA
• George Bause, M.D., M.P.H.
• Alisha Bausone
• Jan R Bautista, MD
• Jocelyn Bautista, MD
• Leomar M Bautista
• Remigio Lopez Bautista, MD
• Kivin Bauzo

• All providers in Cleveland, OH
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; 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.