Active NPI
Catalino Joshua Bautista III, MD
- Diagnostic Radiology Physician
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 01093650A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
- St Mary Medical Center Inc
- St Catherine Hospital Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036089064 | IL | MD | Diagnostic Radiology Physician |
| 01093650A | IN | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munster Radiology Group PC | Diagnostic Radiology | Current | 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.
-
- Diagnostic Radiology Physician
- Munster, IN
- NPI 1144207101
Diagnostic Radiology, IL, IN
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Munster, IN
- NPI 1003918210
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.