NPIMap

Individual provider Active NPI

Brigid B Bautista, MD

  • Psychiatry Physician
  • Phila, PA
National Provider Identifier
1770639080
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD072209L Issued in PA
Practice address
561 Fairthorne Ave
Phila, PA 19128-2412
Phone
(215) 487-4164
Fax
(267) 338-2272
NPI assigned
Jan 27, 2007
Last updated
Mar 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD072209L PA Primary

Addresses

Primary practice location

561 Fairthorne Ave
Phila, PA 19128-2412

Mailing address

561 Fairthorne Ave
Phila, PA 19128-2412
Phone (215) 487-4164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100323000161 PA Practitioner - Psychiatry 8325032295 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Saint Louis University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (215) 831-4600

4900 Wyalusing Ave
Philadelphia, PA 19131-5127
Phone 21547370337124

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
78.42
Improvement activities
40
Cost
70.24

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Council for Mental Health & Mental Retardation Inc CurrentSince Dec 22, 2009 Accepting new patients
Uhs of Pennsylvania Inc Psychiatry Current Accepting new patients
Uhs of Pennsylvania Inc Psychiatry CurrentSince Apr 15, 2014 Accepting new patients
Community Council for Mental Health & Mental Retardation Inc. CurrentSince Dec 22, 2009 Accepting new patients
Eastern Pennsylvania Physician Alliance LLC CurrentSince Jun 1, 2020 Accepting new patients
Horizon House - Delaware Inc Past Accepting new patients

Locations

800 Park Way
Ste A
Broomall, PA 19008
Phone (215) 718-4350

132 The Meadows Dr
Centre Hall, PA 16828
Phone (814) 364-3736

2001 Providence Ave
Chester, PA 19013
Phone (610) 876-9000

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

7170 Lafayette Ave
Ft Washington, PA 19034
Phone (215) 542-4343

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

4900 Wyalusing Ave
Philadelphia, PA 19131
Phone (215) 473-7033

561 Fairthorne Ave
Philadelphia, PA 19128
Phone (215) 487-4000

601 Roxbury Rd
Shippensburg, PA 17257
Phone (717) 532-4217

Organizations & group practices 6

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.

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": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1770639080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 FAIRTHORNE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191282412",
            "telephone_number": "215-487-4164",
            "fax_number": "267-338-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 FAIRTHORNE AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191282412",
            "telephone_number": "215-487-4164",
            "fax_number": "267-338-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "BRIGID",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD072209L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

Verify at the official NPI Registry.