Tricia Bautista, MD

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

330293 Issued in NY

Practice address

55 Water St FL 18
New York, NY 10041-0055

Phone

(510) 708-0921

NPI assigned

Mar 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: tbautista4065940@nychhc.direct-ci.com

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1962039289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 18",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 18",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410055",
            "telephone_number": "510-708-0921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 N Douty St",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932303722",
            "country_code": "US",
            "telephone_number": "559-537-0224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "TRICIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A180675",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NY",
            "license": "330293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Bautista, M.S.ED
• Maria Bautista, LCSW
• Michael Thomas Bautista, RPH
• Nestor Bautista, DPT
• Richard Bautista
• Hannah Bava, MD
• Saliha Bava, PH.D., LMFT
• Nicholas A. Bavaro, M.D.
• Tamara G Bavendam, M.D.
• Rocco J Bavero, C.P.R.A.P

• Addiction Medicine (Family Medicine) Physician in New York, NY
• Providers in New York, NY by specialty
• Addiction Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.