MANUEL M BAUTISTA (NPI# 1093793689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093793689 |
| Entity Type | Individual |
| Full Name | MANUEL M BAUTISTA |
| Credential | MD |
| Practice Address |
960 Windham Ct Suite 1 Boardman OH 44512-5087 |
| Mailing Address |
Po Box 378 Sandusky OH 44871-0378 |
| Practice Telephone | 3307263357 |
| Practice Fax Number | 3307261465 |
| Mailing Telephone | 4196091112 |
| Mailing Fax Number | 4196091123 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
35089622 | OH | Allopathic & Osteopathic Physicians |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
35089622 | OH | Allopathic & Osteopathic Physicians |
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
35089622 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2475585 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376634808 | Manuel Francisco Bautista | Psychiatry & Neurology | 9115 Bridgeport Way Sw, Ste 1, Lakewood, WA 98499-2499 | 2006-09-28 |
| Street Address |
960 WINDHAM CT SUITE 1 |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-5087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750534509 | Jennifer L Cicchillo | Nurse Practitioner | 960 Windham Ct, Boardman, OH 44512-5087 | 2008-10-24 |
| 1134199433 | Lawrence S Goldstein | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-26 |
| 1801866439 | Rebecca S Bailey | Internal Medicine | 960 Windham Ct, Boardman, OH 44512-5087 | 2006-01-25 |
| 1760452304 | Ritha Kartan | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-25 |
| 1235117276 | Eastern Ohio Pulmonary Consultants Inc | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689114027 | Associates In Pulmonary and Critical Care Medicine Inc | Internal Medicine | 250 Debartolo Place, Suite 1630, Boardman, OH 44512-6088 | 2017-03-05 |
| 1861937179 | Island Medical Vibra LLC | Internal Medicine | 8049 South Ave, Boardman, OH 44512-6154 | 2016-12-21 |
| 1134199433 | Lawrence S Goldstein | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-26 |
| 1801866439 | Rebecca S Bailey | Internal Medicine | 960 Windham Ct, Boardman, OH 44512-5087 | 2006-01-25 |
| 1760452304 | Ritha Kartan | Internal Medicine | 960 Windham Ct, Suite 1, Boardman, OH 44512-5087 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891236733 | Jing Gennie Wang | Internal Medicine | 473 W 12th Ave Ste 201, Columbus, OH 43210-1252 | 2017-03-11 |
| 1083093546 | Waleed F Nemer Md Inc | Internal Medicine | 908 E Waterloo Rd Ste 1a, Akron, OH 44306-3928 | 2015-05-29 |
| 1578905089 | Bassel Akbik | Internal Medicine | 18099 Lorain Ave # 250, Cleveland, OH 44111 | 2013-07-25 |
| 1083059182 | Matthew Thomas Siuba | Internal Medicine | 9500 Euclid Ave # L2-300, Cleveland, OH 44195-0001 | 2013-05-02 |
| 1831431162 | David Healy Do Pulmonary Medicine LLC | Internal Medicine | 3693 Darby Knolls Blvd, Hilliard, OH 43026-7293 | 2013-03-25 |
| 1417207010 | Jeffrey David Parker | Internal Medicine | 2121 Herrick Ave., Cincinnati, OH 45208-3214 | 2012-09-12 |
| 1780947077 | Ayman O Alsharbini | Internal Medicine | 425 West 5th St, East Liverpool, OH 43920 | 2012-06-21 |
| 1386942910 | Pulmonary Associates LLC | Internal Medicine | 3006 N. Dixie Hwy., Suite 102, Troy, OH 45373 | 2011-03-07 |
| 1144523630 | Jordan Atanasov Kazakov | Internal Medicine | 11100 Euclid Ave # Bolwell 6, Cleveland, OH 44106-1716 | 2010-12-06 |
| 1649402751 | Anthony Michael Boulos | Internal Medicine | 960 Windham Ct Ste 1, Youngstown, OH 44512-5087 | 2009-08-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.