Dr Mario Bautista, MD is a
Pediatrics physician based in Jackson, Ohio. Dr Mario Bautista is licensed to practice in Ohio (license number 35.089012) and his current practice location is 1000 Veterans Dr, Jackson, Ohio. He can be reached at his office (for appointments etc.) via phone at
(740) 395-8090.
NPI number for Dr Mario Bautista is 1619955192 and his current mailing address is 272 Hospital Rd Ste 6, Chillicothe, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619955192.
Physician's Profile
| Full Name | Dr Mario Bautista |
|---|
| Gender | Male |
|---|
| Speciality | Pediatrics |
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| Location | 1000 Veterans Dr, Jackson, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1619955192
- Provider Enumeration Date: 01/05/2006
- Last Update Date: 11/25/2020
Medical Identifiers
Medical identifiers for Dr Mario Bautista such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1619955192 | NPI | - | NPPES |
| 10016535 | Other | NM | LOVELACE HEALTH/SALUD |
| P00137209 | Other | | RAILROAD MEDICARE |
| PROVP11655 | Other | NM | MOLINA |
| 201047701 | Other | NM | PRESBYTERIAN HEALTH/SALUD |
| 2711211 | Medicaid | OH | |
| 885808 | Other | AZ | AHCCCS |
| 99238071 | Medicaid | NM | |
| NM009R63 | Other | NM | BC/BS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 2004-0547 (New Mexico) | Secondary |
| 2080P0204X | Pediatrics - Pediatric Emergency Medicine | 2004-0547 (New Mexico) | Secondary |
| 208000000X | Pediatrics | 35.089012 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mario Bautista is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mario Bautista, MD
272 Hospital Rd Ste 6,
Chillicothe, OH 45601-9031
Ph: (740) 779-4275 | Dr Mario Bautista, MD
1000 Veterans Dr,
Jackson, OH 45640-9586
Ph: (740) 395-8090 |
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