DR. JONATHAN BAUTISTA (DPT) – Physical Therapist, NPI 1053142463

DR. JONATHAN BAUTISTA (DPT) is a healthcare provider. based in Las vegas, Nevada. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 6522 (NV). The NPI Number for DR. JONATHAN BAUTISTA (DPT) is 1053142463

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. JONATHAN BAUTISTA (DPT)
NPI
1053142463
Phone
(775) 742-7133
Address
6631 CREEPING THYME ST
Enumeration Date
8 August 2024
Last Update Date
12 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7257267847
Graduation Year
2024 (2 years ago)
PAC ID
0143760215
Group Practice PAC ID
1052731072
Professional Enrollment ID
I20240904003809
Address ID
NV891105384LA727XXBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

880 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NV

Provider Addresses for DR. JONATHAN BAUTISTA (DPT)

  • 6631 CREEPING THYME ST

    LAS VEGAS, NV 891484801

    Phone: (775) 742-7133

    Type: Mailing

  • 4000 S EASTERN AVE STE 150

    LAS VEGAS, NV 891190840

    Phone: (725) 726-7847

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240904003809IPhysical Therapist In Private PracticeNVTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 89148)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1052731072View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeNV
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeNV
Occupational Therapist In Private PracticeNV

Reviews

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Frequently asked questions

How do payers reference DR. JONATHAN BAUTISTA (DPT)?
For DR. JONATHAN BAUTISTA (DPT), use NPI 1053142463 as the unique 10-digit identifier.
Active or inactive — what applies to DR. JONATHAN BAUTISTA (DPT)?
You should see DR. JONATHAN BAUTISTA (DPT) as active in CMS-hosted NPPES data.
What clinical focus is listed for DR. JONATHAN BAUTISTA (DPT)?
At a glance, DR. JONATHAN BAUTISTA (DPT) is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
Is DR. JONATHAN BAUTISTA (DPT) associated with Las Vegas?
Public fields place DR. JONATHAN BAUTISTA (DPT) around Las Vegas, Nevada. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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