Rainier Dennis Dimaandal Bautista, M.D.
Individual provider Active NPI Family Medicine Physician · Lihue, HI
NPI 1962766972 · NPPES record last updated Nov 4, 2016
Key facts
- NPI
- 1962766972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD 18262 (HI)
- Practice address
- 3216 Elua St
Lihue, HI 96766-1213 - Phone
- (808) 246-3800
- Fax
- (808) 246-3801
- NPI assigned
- Jun 25, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Charlie Y Sonido M D LLC
Practice addresses (Care Compare)
3216 Elua St
Lihue, HI 96766-1213
Phone (808) 246-3800
Hospital & facility affiliations
- Islands Hospice
- The Queens Medical Center
- Wilcox Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151023001149 | HI | Practitioner - Family Practice | 5991014482 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 18262 | HI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestones | Current |
Accepting new patients | |
| Islands Hospice, Inc. | Family Medicine | Current |
Accepting new patients |
| Charlie Y Sonido M D LLC | Current |
Accepting new patients |
Locations
12680 High Bluff Dr
Ste 150
San Diego, CA 92130
820 Mililani St
Ste 400
Honolulu, HI 96813
Phone (808) 550-2552
1807 N King St
Ste 101
Honolulu, HI 96819
Phone (808) 841-4195
94-837 Waipahu St
#100
Waipahu, HI 96797
Phone (808) 671-3911
94-837 Waipahu St
Waipahu, HI 96797
Phone (808) 671-3911
Interoperability endpoints
- https://api.platform.athenahealth.com/17047/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD 18262 | HI | Yes |
Addresses
Primary practice location
3216 Elua St
Lihue, HI 96766-1213
Mailing address
3216 Elua St
Lihue, HI 96766-1213
Phone (323) 229-9640
Other providers in Lihue, HI
- Jaffia Cybele Ballesteros
- Christine Amanda Baptiste Freeman
- Karen T Barbadillo
- Kimberly Barnes
- Susan Helene Barretto
- Bayada Home Care
- Jacqueline Baker Belding
- Bennett Jacoby DDS Ms Inc.
- Elvie Rose Bisarra
- Candace H. Bishop
All providers in Lihue, HI · Family Medicine Physician in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.