Individual provider Active NPI

Catalino Joshua Bautista III, MD

  • Diagnostic Radiology Physician
  • Loma Linda, CA
National Provider Identifier
1669969234
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01093650A Issued in IN
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4000
NPI assigned
Apr 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036089064 IL
Vascular & Interventional Radiology Physician 2085R0204X 01093650A IN
Diagnostic Radiology Physician 2085R0202X 01093650A IN Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-4000

Other practice location 1

1000 W Carson St
Torrance, CA 90502-2004
Phone (310) 222-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240801001051 IN Practitioner - Diagnostic Radiology 2961949524 Reassigns benefits to 2 organizations
I20240813002490 IL Practitioner - Diagnostic Radiology 2961949524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munster Radiology Group PCGroup PAC ID 1951299940, 26 clinicians
Powers Health Diagnostic Group LLCGroup PAC ID 8820573280, 25 clinicians

Practice addresses (Care Compare)

10020 Don S Powers Dr
Munster, IN 46321-4054
Phone (219) 836-4599

10191 Broadway
Crown Point, IN 46307-8801
Phone (219) 661-6100

10215 Broadway
Crown Point, IN 46307-8001
Phone (219) 703-4550

1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone (219) 942-0551

1602 Butterfield Rd
Flossmoor, IL 60422-1835
Phone (219) 924-3450

300 W 61St Ave
Hobart, IN 46342-6490
Phone (219) 947-6435

3545 Arbor Blvd
Portage, IN 46368-4298
Phone (219) 947-6729

3800 Saint Mary Rd
Valparaiso, IN 46383-3986
Phone (219) 286-3700

416 Justina St
Hinsdale, IL 60521-2419
Phone (219) 924-3450

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-1700

7651 Harvest Dr
Schererville, IN 46375-3476
Phone (219) 322-5723

901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-1600

9660 Wicker Ave
Saint John, IN 46373-9487
Phone (219) 365-1166

Hospital & facility affiliations

  • Community Hospital Hospital, Munster, IN, CCN 150125
  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034
  • St Catherine Hospital Inc Hospital, East Chicago, IN, CCN 150008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036089064ILMDDiagnostic Radiology Physician
01093650AINMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munster Radiology Group PC Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1669969234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "CATALINO",
        "middle_name": "JOSHUA",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-18",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036089064",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01093650A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01093650A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.