Samantha Timpog Bautista

Primary specialty

OptometristTaxonomy code 152W00000X

License

33550 Issued in CA

Practice address

4 Embarcadero Ctr # LL3
San Francisco, CA 94111-4106

Phone

(415) 772-8282

NPI assigned

Jul 26, 2016

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peninsula Ophthalmology Group, Inc.

  • Ophthalmology Physician
  • Burlingame, CA
  • NPI 1447303995
  Medicare reassignment NPD

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1780137778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 ROCCA AVE",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940802653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 EMBARCADERO CTR # LL3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941114106",
            "telephone_number": "415-772-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "SAMANTHA",
        "middle_name": "TIMPOG",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lord Mark Bautista
• Marianne Bautista
• Rhea Bautista
• Ronnie Bautista, LCSW
• Rosh Marguerite Marguerite Bautista, MS
• Victor Bautista, O.D.
• Shivali Baveja, MD
• Sanjiv M Baxi, M.D.
• Catherine Baxley, PHD
• Rochelle Jeannine Baxter Green

• Optometrist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.