NPIMap

Individual provider Active NPI

Lucien S Bautista, DO

  • Family Medicine Physician
  • Phillipsburg, NJ
National Provider Identifier
1982663480
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB68661 Issued in NJ
Practice address
200 Strykers Rd
Phillipsburg, NJ 08865-9488
Phone
(908) 859-6568
Fax
(908) 859-6697
NPI assigned
Mar 22, 2006
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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 MB68661 NJ Primary

Addresses

Primary practice location

200 Strykers Rd
Phillipsburg, NJ 08865-9488

Mailing address

PO Box 27957
Salt Lake City, UT 84127-0957
Phone (908) 835-1910

Other identifiers 1

IdentifierTypeStateIssuer
080176344OtherNJRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100408000283 NJ Practitioner - Family Practice 1355477852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers New Jersey Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
H2 Rehabilitation Extension Services LLCGroup PAC ID 6406131622, shared by 5 NPIs, 161 clinicians

Practice addresses (Care Compare)

200 Strykers Rd
Phillipsburg, NJ 08865-9488
Phone (908) 847-1035

313 S Walnut St
Suite 1
Bath, PA 18014-1024
Phone (484) 425-0297

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB68661NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Warren Physician Group, PC Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Jul 1, 1999 Accepting new patients
St. Luke's Warren Physician Group, PC Family Medicine CurrentSince Jul 1, 1999 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients

Locations

185 Roseberry St
Bldg 2ND
Phillipsburg, NJ 08865
Phone (908) 847-2619

200 State Route 57
Phillipsburg, NJ 08865
Phone (908) 454-3737

200 Strykers Rd
Phillipsburg, NJ 08865
Phone (908) 847-1035

207 Strykers Rd
Phillipsburg, NJ 08865
Phone (908) 847-6568

409 Coventry Dr
Phillipsburg, NJ 08865
Phone (908) 213-0029

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

Interoperability endpoints

  • Direct secure messaging: luceien.bautista@slpg.direct-sluhn.org

Organizations & group practices 4

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 12

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1982663480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27957",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270957",
            "telephone_number": "908-835-1910",
            "fax_number": "908-835-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STRYKERS RD",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088659488",
            "telephone_number": "908-859-6568",
            "fax_number": "908-859-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "LUCIEN",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB68661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080176344",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

Verify at the official NPI Registry.