MR. MARIO BAUTISTA SY (NPI# 1447210638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447210638 |
| Entity Type | Individual |
| Full Name | MR. MARIO BAUTISTA SY |
| Credential | M.D. |
| Practice Address |
1351 Kimberly Rd Ste 100 Bettendorf IA 52722-4193 |
| Practice Telephone | 5633557733 |
| Practice Fax Number | 5633559077 |
| Mailing Telephone | 5633557733 |
| Mailing Fax Number | 5633559077 |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2012-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 34978 | IA | Other Service Providers |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
34978 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FEDERAL TAX INDENTIFICATI | 421423259 | 01 | |
| IA | 2110700 | 05 | |
| WELLMARK BC BS | 34565 | 01 |
| Street Address |
1351 KIMBERLY RD STE 100 |
| City | BETTENDORF |
| State | IA |
| Zip Code | 52722-4193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497406 | Sheila K Barngrover | Nurse Practitioner | 1351 Kimberly Rd, Suite 100, Bettendorf, IA 52722-4194 | 2005-06-20 |
| 1578639126 | Hematology-oncology Associates of The Quad Cities, PC | Internal Medicine | 1351 Kimberly Rd, Ste 100, Bettendorf, IA 52722-4193 | 2006-11-27 |
| 1184684987 | Shobha Rani Chitneni | Specialist | 1351 Kimberly Rd, Ste 100, Bettendorf, IA 52722-4193 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770198855 | Wellspire-bettendorf LLC | Skilled Nursing Facility | 4699 53rd Ave, Bettendorf, IA 52722 | 2020-09-15 |
| 1558873315 | Erin M Kohrt | Speech-Language Pathologist | 2500 Grant Street, Bettendorf, IA 52722 | 2017-11-01 |
| 1437680295 | Holli Christine Martin | Chiropractor | 3048 Victoria St., Bettendorf, IA 52722 | 2017-03-23 |
| 1598219552 | Alyssa Renee Matz | Counselor | 2435 Kimberly Rd Ste 96, Bettendorf, IA 52722 | 2016-08-08 |
| 1144625021 | Athletico Ltd | Physical Therapist | 3252 Ridge Point, Bettendorf, IA 52722 | 2014-11-04 |
| 1609282862 | Katherine L Browne | Nurse Practitioner | 1351 Kimberly Rd Ste 100, Bettendorf, IA 52722 | 2014-07-09 |
| 1316357494 | Kayla Leigh Ehrman | Family Medicine | 2535 Maplecrest Rd Ste 16, Bettendorf, IA 52722 | 2014-04-29 |
| 1043648454 | Duane Anthony Halbur Jr. | Counselor | 2420 Salem Ct, Bettendorf, IA 52722 | 2013-10-22 |
| 1376881185 | Christopher D Murphy | Physical Therapist | 2300 53rd Ave Ll02, Bettendorf, IA 52722 | 2013-01-29 |
| 1326386574 | Kelly C Harry | Occupational Therapist | 3470 Utica Ridge Road, Suite 4, Bettendorf, IA 52722 | 2013-01-23 |
| Find all providers in zip 52722 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578639126 | Hematology-oncology Associates of The Quad Cities, PC | Internal Medicine | 1351 Kimberly Rd, Ste 100, Bettendorf, IA 52722-4193 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649649377 | Medical Oncology and Hematology Associatges Ptrshp | Internal Medicine | 12495 University Ave, Suite 200, Clive, IA 50325-8289 | 2015-09-23 |
| 1154646149 | Hussain M Naseri | Internal Medicine | 200 E Ridgeway Ave Ste 400, Waterloo, IA 50702 | 2010-04-01 |
| 1356584080 | Tara Michelle Graff | Internal Medicine | 411 Laurel Street Suite A300, Des Moines, IA 50314 | 2009-04-10 |
| 1801063243 | Chitra Devi Anangur Ganesan | Internal Medicine | 1000 4th Street, Sw, Mercy Medical Center, Mason City, IA 50401 | 2008-05-14 |
| 1811169972 | Stacey Marie Parker-brueggemann | Internal Medicine | 1 Edmundson Pl Ste 100, Council Bluffs, IA 51503-4658 | 2008-03-28 |
| 1205908563 | Cancer Care of Iowa City LLC | Internal Medicine | 613 E Bloomington, Suite 100 Cancer Care of Iowa City, Iowa City, IA 52245 | 2006-11-14 |
| 1356352116 | Susannah Parker Friemel | Internal Medicine | 1750 E 53rd Street, Davenport, IA 52807 | 2006-08-10 |
| 1215980602 | Jasjeet Singh Sangha | Internal Medicine | 3530 West 4th Street, Waterloo, IA 50701-4503 | 2006-05-18 |
| 1033169768 | Christine Marie Holm | Internal Medicine | 150 Mercy Dr., Dubuque, IA 52001-7301 | 2006-05-11 |
| 1588628101 | Robert R Shreck | Internal Medicine | 1221 Pleasant Street, #100, Des Moines, IA 50309 | 2006-04-12 |
| Find all providers with the same taxonomy | ||||
| City | BETTENDORF |
| Zip Code | 52722 |
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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.