Marita C Bautista, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

123660 Issued in CA

Practice address

901 Nevin Ave
Richmond, CA 94801-3143

Phone

(510) 307-1555

NPI assigned

Mar 14, 2012

Sex

Female

Sole proprietor

No

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.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299

  CA, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Permanente Medical Group, Inc.

  • Clinical Medical Laboratory
  • Berkeley, CA
  • NPI 1083777163
  Care Compare group
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510

  Internal Medicine

  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• 21St Century Home Health Services Inc

  • Home Health Agency
  • Burlingame, CA
  • NPI 1184013369
  Care Compare affiliation
• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1427123132

  Hospital

  Care Compare affiliation

Specialty

Internal Medicine

Education

Medical College of Wisconsin, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Permanente Medical Group Inc 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• 21St Century Home Health Services Inc. Home health agency, Burlingame, CA, CCN 059725
• Kaiser Foundation Hospital - Oakland/Richmond Hospital, Oakland, CA, CCN 050075

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 15, 2021.

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1851666473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 NEVIN AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948013143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 NEVIN AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948013143",
            "telephone_number": "510-307-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "MARITA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-14",
        "last_updated": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "123660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "901 Nevin Ave",
            "city": "Richmond",
            "state": "CA",
            "country_code": "US",
            "postal_code": "948013143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heidi Marie Bauer, M.D.
• Camila Adoracion Baum, LCSW
• Arilenne Bautista
• Hayzell Bautista
• Karen Bautista
• Bay Area Behavior Consultants
• Bay Area Community Resources, Inc
• Bay Area Community Resources, Inc
• Bay Area Community Resources, Inc
• Bay Area Community Resources, Inc

• All providers in Richmond, CA
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.
• 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.

Verify at the official NPI Registry.