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MS. SAMANTHA ROSE BAUTISTA LMHC
NPI 1124960224
Counselor - Mental Health in Glen Cove, NY

Active since April 07, 2026PECOS Enrolled
113 GLEN COVE AVE, GLEN COVE, NY 11542(516) 622-8888 Get Directions Write a Review

NPPES record last updated: April 7, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Ms. Samantha Rose Bautista Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SAMANTHA ROSE BAUTISTA LMHC (NPI 1124960224) is an individual mental health provider in Glen Cove, New York, licensed in New York (015486) and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1124960224
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. SAMANTHA ROSE BAUTISTACredential: LMHC
Location Address113 GLEN COVE AVEGlen Cove, NY 11542-3438
Mailing Address36 Hennessey DrHuntington, NY 11743-3828 · (516) 622-8888
Phone(516) 622-8888
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 7, 2026
NPPES CertifiedApril 7, 2026
✔ NPI 1124960224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 015486
113 GLEN COVE AVE, Glen Cove, NY 11542
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Samantha Rose Bautista Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698241388
PECOS Enrollment IDI20260420002529
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Bautista reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Charles Evans Center, Inc
Same address
Mental Health (Including Community Mental Health Center)
113 GLEN COVE AVE
Glen Cove, NY 11542
  • Reassigned Medicare billing, New York enrollment
  • 66 clinicians in this Medicare group
NPI 1770142366 (516) 676-2388

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL GIEDT NP
Nurse Practitioner (Psychiatric/Mental Health)
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (516) 676-2388
DORIS WADE LPN
Licensed Practical Nurse
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (516) 676-2388
SILVANA ST ONGE LMSW
Social Worker
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (516) 622-8888
SARAH CUPKA LMHC
Counselor (Mental Health)
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (516) 676-2388
ANGELO J. MELILLO CENTER FOR MENTAL HEALTH, INC.
Community/Behavioral Health
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (516) 676-2388
MRS. JANE COLLINS LCSW
Social Worker (Clinical)
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (516) 676-2388
CHARLES EVANS CENTER, INC.
Community Based Residential Treatment Facility, Mental Illness
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (516) 676-2388
GAELLE EUSTACHE
Registered Nurse
113 GLEN COVE AVE
GLEN COVE, NY 11542
Nassau County (151) 662-2888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Bautista's NPI number?

The NPI number for Samantha Bautista is 1124960224. It was assigned to this individual provider in the NPPES registry on April 7, 2026.

Where is Samantha Bautista located?

Samantha Bautista practices at 113 Glen Cove Ave, Glen Cove, NY 11542. The listed phone number is (516) 622-8888.

What is Samantha Bautista's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Samantha Bautista enrolled in Medicare?

Yes. Samantha Bautista is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samantha Bautista's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Bautista reassigns Medicare benefits to Charles Evans Center, Inc (Glen Cove, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Bautista's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samantha Bautista was last updated on April 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.