Individual provider Active NPI

Rainier Dennis Dimaandal Bautista, M.D.

  • Family Medicine Physician
  • Lihue, HI
National Provider Identifier
1962766972
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD 18262 Issued in HI
Practice address
3216 Elua St
Lihue, HI 96766-1213
Phone
(808) 246-3800
Fax
(808) 246-3801
NPI assigned
Jun 25, 2012
Last updated
Nov 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD 18262 HI Primary

Addresses

Primary practice location

3216 Elua St
Lihue, HI 96766-1213

Mailing address

3216 Elua St
Lihue, HI 96766-1213
Phone (323) 229-9640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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

Enrollment IDStateProvider typePAC IDDetails
I20151023001149 HI Practitioner - Family Practice 5991014482 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlie Y Sonido M D LLCGroup PAC ID 8224931928, 18 clinicians

Practice addresses (Care Compare)

3216 Elua St
Lihue, HI 96766-1213
Phone (808) 246-3800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 18262HIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlie Y Sonido M D LLC CurrentSince Dec 1, 2015 Accepting new patients
Islands Hospice, Inc. Family Medicine CurrentSince Apr 26, 2025 Accepting new patients
Milestones CurrentSince Apr 26, 2025 Accepting new patients

Locations

12680 High Bluff Dr
Ste 150
San Diego, CA 92130

1807 N King St
Ste 101
Honolulu, HI 96819
Phone (808) 841-4195

820 Mililani St
Ste 400
Honolulu, HI 96813
Phone (808) 550-2552

94-837 Waipahu St
Waipahu, HI 96797
Phone (808) 671-3911

94-837 Waipahu St
#100
Waipahu, HI 96797
Phone (808) 671-3911

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17047/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1962766972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 ELUA ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661213",
            "telephone_number": "323-229-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 ELUA ST",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661213",
            "telephone_number": "808-246-3800",
            "fax_number": "808-246-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "RAINIER DENNIS",
        "middle_name": "DIMAANDAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD 18262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

Verify at the official NPI Registry.