Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1619955192 Individual Practitioner Male Practitioner

Dr. Mario Bautista , MD

Pediatrics • Jackson, OH

Professional Overview & Biography Verified Profile Summary

Dr. Mario Bautista, MD is a registered healthcare professional specializing in Pediatrics in Jackson, OH. Practice services are available at 1000 VETERANS DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1000 Veterans Dr

Jackson, OH 456409586

Telephone 7403958090
Fax 7403958197
Associated Practice Facility / Clinic
🏢 Adena Health System Facility NPI 1457538324

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Jackson, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Jackson, OH (3057 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-11-25
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License OH 35.089012

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License NM 2004-0547

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics - Pediatric Emergency Medicine

NUCC Taxonomy Code: 2080P0204X

State License NM 2004-0547

A pediatrician who has special qualifications to manage emergencies in infants and children.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
99238071 (NM)
Medicaid State Provider ID
2711211 (OH)
Commercial Insurance / Payer ID Molina
PROVP11655 (NM)
Commercial Insurance / Payer ID Presbyterian Health/salud
201047701 (NM)
Commercial Insurance / Payer ID Ahcccs
885808 (AZ)
Commercial Insurance / Payer ID Lovelace Health/salud
10016535 (NM)
Commercial Insurance / Payer ID Bc/bs
NM009R63 (NM)
Commercial Insurance / Payer ID Railroad Medicare
P00137209

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Susan Lykins , CNP

Nurse Practitioner - Family

NPI 1154673721

Certified Nurse Practitioner

NPI 1184990368

Doctor of Osteopathic Medicine (D.O.)

Dr. Stephen Owen , DO

Family Medicine

NPI 1205854353

Doctor of Osteopathic Medicine (D.O.)

Amanda Strickland , FNP

Nurse Practitioner - Family

NPI 1285078352

Family Nurse Practitioner

Alicia Kammler , CNP

Nurse Practitioner

NPI 1407841992

Certified Nurse Practitioner

Jennifer Duncan , CNP

Nurse Practitioner - Family

NPI 1710291604

Certified Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location March 22, 2019

Registered at 1000 VETERANS DR, JACKSON, OH 456409586 (Tel: 7403958090)

📍
Updated Business Mailing Address March 22, 2019

Registered at 272 HOSPITAL RD STE 6, CHILLICOTHE, OH 456019031 (Tel: 7407794275)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2019

Pediatrics (License #35.089012 in OH)

NPI Profile Active November 02, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location November 02, 2011

Registered at 102 TWIN OAKS DR, JACKSON, OH 456409506 (Tel: 7402860469)

📍
Updated Business Mailing Address November 02, 2011

Registered at 102 TWIN OAKS DR, JACKSON, OH 456409506 (Tel: 7402860469)

👤
Provider Name / Credentials Updated November 02, 2011

Recorded as MARIO BAUTISTA, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 02, 2011

Pediatrics (License #35.089012 in OH)

🟢
Initial NPI Registration & Enumeration January 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619955192
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 05, 2006
Last Update: November 25, 2020
Sole Proprietor: No

Mailing Address

272 Hospital Rd Ste 6

Chillicothe, OH 456019031

Phone: 7407794275

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.