Lina Judith Bautista, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

2785 Issued in AK

Practice address

2800 Providence Dr
Anchorage, AK 99508-4623

Phone

(907) 269-7152

Fax

(907) 269-7251

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Providence Health & Services- Washington

  • Critical Care Medicine (Internal Medicine) Physician
  • Anchorage, AK
  • NPI 1093956278
  NPD (past)
• State of Alaska

  • Psychiatry Physician
  • Anchorage, AK
  • NPI 1811027519
  NPD (past)
• State of Alaska Department of Administration

  • Psychiatric Hospital
  • Anchorage, AK
  • NPI 1497842553
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in AK

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

Practice roles

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982625596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 PROVIDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084623",
            "telephone_number": "907-269-7152",
            "fax_number": "907-269-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 PROVIDENCE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084623",
            "telephone_number": "907-269-7152",
            "fax_number": "907-269-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "LINA",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AK",
            "license": "2785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD02182",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Bauman, CCM
• Jessica M Bauman, SLP
• Jeanine Fleming Baumann, RD
• Angeluzky Mercedes Bautista
• Erick Bautista
• Shannon Bautista
• Adam Carmen Baxter, PHARMD
• Debra J Baxter, RN
• Marshall Baxter, CRNA
• Michael Baxter, PA-C

• All providers in Anchorage, AK
• Child & Adolescent Psychiatry Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.