Teofilo S Bautista, M.D., P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01032450 Issued in IN

Practice address

642 S Lake St
Gary, IN 46403-2967

Phone

(219) 938-4481

Fax

(219) 938-6480

NPI assigned

Jul 12, 2005

Sex

Male

Sole proprietor

No

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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.

• Nwi Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Munster, IN
  • NPI 1043596703

  Family Medicine

  NPD (past)
• The Methodist Hospitals, Inc

  • Internal Medicine Physician
  • Gary, IN
  • NPI 1720290349
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1801894076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8135 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-513-2000",
            "fax_number": "219-513-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 S LAKE ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464032967",
            "telephone_number": "219-938-4481",
            "fax_number": "219-938-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "TEOFILO",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01032450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100169010A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douge Barthelemy, M.D.
• Nathalie Maherani Batchassi, APN
• Michelle Bates-Leon, MSW
• Jessyca Mecole Batiest
• Brian Bauner
• Lori D. Beard
• Become Fabulous
• Lierin Elizabeth Beecher, BA, CADAC II
• Ladonna Lucille Bell
• Marshall J Belmer, DDS

• All providers in Gary, IN
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; 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.