Active NPI
Roger Bautista, D.O.
- Emergency Medicine Physician
- Hanford, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- OS19273
- Practice address
- 115 Mall Dr
Hanford, CA 93230-5786 - Phone
- (559) 582-9000
- NPI assigned
- Nov 15, 2005
- Last updated
- Feb 14, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 42078 | CO | |
| Emergency Medicine Physician | 207P00000X | 70711 | GA | |
| Emergency Medicine Physician | 207P00000X | 20A9319 | CA | |
| Emergency Medicine Physician | 207P00000X | OS19273 | FL | Primary |
Addresses
Primary practice location
115 Mall Dr
Hanford, CA 93230-5786
Mailing address
1601 Cummins Dr Ste D
Modesto, CA 95358-6411
Phone (510) 851-7423
Other practice location 1
9501 Farrell Rd
Fort Belvoir, VA 22060-5901
Phone (703) 805-0599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13139 Sorrento Rd
Pensacola, FL 32507-8777
Phone (850) 746-0020
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 70.94
- Improvement activities
- 40
- Cost
- 92.94
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A9319 | CA | MD | Emergency Medicine Physician |
| 42078 | CO | MD | Emergency Medicine Physician |
| 70711 | GA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Cep America, LLC | Emergency Medicine | Current | Accepting new patients |
| Cep America - California | Emergency Medicine | Current | Accepting new patients |
| Cep America-California | Emergency Medicine | Current | Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Wildwood Sanitarium Incorporated | Current | Accepting new patients | |
| Anaheim Global Medical Center, Inc | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1025 N Douty St
Hanford, CA 93230
Phone (559) 537-0170
115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603
13139 Sorrento Rd
Pensacola, FL 32507
Phone (850) 492-0543
435 Life Style Ln
Wildwood, GA 30757
Phone (706) 419-0023
Organizations & group practices 8
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.
-
- Emergency Medicine Physician
- Miramar Beach, FL
- NPI 1295442614
-
- Emergency Medicine Physician
- Murrieta, CA
- NPI 1588552848
-
- Emergency Medicine Physician
- Saint Johns, FL
- NPI 1073200069
-
- Emergency Medicine Physician
- Fort Lauderdale, FL
- NPI 1700747946
-
dba Wildwood Medical Clinic
- General Acute Care Hospital
- Wildwood, GA
- NPI 1902957541
-
dba Anaheim Global Medical Center
- General Acute Care Hospital
- Anaheim, CA
- NPI 1790778488
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Ascension Sacred Heart Bay
- General Acute Care Hospital
- Panama City, FL
- NPI 1720078041
-
dba Ascension Sacred Heart Pensacola
- General Acute Care Hospital
- Pensacola, FL
- NPI 1922032424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707868800000",
"number": "1902888084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 CUMMINS DR STE D",
"city": "MODESTO",
"state": "CA",
"postal_code": "953586411",
"telephone_number": "510-851-7423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MALL DR",
"city": "HANFORD",
"state": "CA",
"postal_code": "932305786",
"telephone_number": "559-582-9000"
}
],
"practiceLocations": [
{
"address_1": "9501 Farrell Rd",
"address_purpose": "LOCATION",
"city": "Fort Belvoir",
"state": "VA",
"postal_code": "220605901",
"country_code": "US",
"telephone_number": "703-805-0599",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAUTISTA",
"first_name": "ROGER",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CO",
"license": "42078",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "70711",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "20A9319",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "OS19273",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hanford, CA
- Basit Medical Inc
- Kimberley Bassett
- Paramjot Kaur Bath
- Baum 5 Star Healthcare
- Reyna P Bautista
- Stormie S Baxter, M. ED.
- Bayrakdarian Hanford DMD Inc a California Professional Dental Office C (Unique Orthodontics Hanford)
- Baz Allergy, Asthma & Sinus Center, Inc.
- Stephanie Bealer
- Roger Donald Bean, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.