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MARVIN ICBAN BAUTISTA D.C.
NPI 1215012778
Chiropractor in San Bruno, CA

Active since October 25, 2006
931 SAN BRUNO AVE W RM 7, SAN BRUNO, CA 94066(650) 225-0500(650) 225-0510 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Marvin Icban Bautista D.c. NPPES

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

MARVIN ICBAN BAUTISTA D.C. (NPI 1215012778) is an individual chiropractor in San Bruno, California, licensed in California (DC28034) and active in the NPI registry since October 2006. He is a graduate of Palmer College Chiropractic - West Sunnyvale (2001).

NPPES Registry Identity

NPI1215012778
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameMARVIN ICBAN BAUTISTACredential: D.C.
Location Address931 SAN BRUNO AVE W RM 7San Bruno, CA 94066-3435
Mailing Address130 Yolo CtSan Bruno, CA 94066-2555 · (650) 892-3669 · Fax (650) 225-0510
Phone(650) 225-0500
Fax(650) 225-0510
Sole ProprietorYes
Medical School CMSPalmer College Chiropractic - West SunnyvaleGraduated 2001
Enumeration DateOctober 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1215012778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in CA · DC28034
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
931 SAN BRUNO AVE W RM 7, San Bruno, CA 94066
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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)

Marvin Icban Bautista D.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1254300619
PECOS Enrollment IDI20041001000385

Medicare Billing Reassignment

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

Bautista Chiropractic Care Inc
Same address
Chiropractor
931 SAN BRUNO AVE W RM 7
San Bruno, CA 94066
  • Reassigned Medicare billing, California enrollment
NPI 1174662530 (650) 225-0500

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

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chiropractic manipulative treatment, 3-4 spinal regions 98941
Chiropractic manipulative treatment for 3-4 spinal regions involves a trained professional applying controlled force to specific areas of your spine. This can help alleviate pain, improve physical function, and support your body's natural healing process.
241 services29 patients

Other Providers at the Same Location NPPES 3

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

BAUTISTA CHIROPRACTIC CARE INC
Chiropractor
931 SAN BRUNO AVE W RM 7
SAN BRUNO, CA 94066
San Mateo County (650) 225-0500
ARANIBAR CHIROPRACTIC CARE, INC
Chiropractor
931 SAN BRUNO AVE W RM 7
SAN BRUNO, CA 94066
San Mateo County (650) 225-0540
JORGE ANTONIO ARANIBAR D.C.
Chiropractor
931 SAN BRUNO AVE W RM 7
SAN BRUNO, CA 94066
San Mateo County (650) 225-0540

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 Marvin Bautista's NPI number?

The NPI number for Marvin Bautista is 1215012778. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Marvin Bautista located?

Marvin Bautista practices at 931 San Bruno Ave W Rm 7, San Bruno, CA 94066. The listed phone number is (650) 225-0500.

What is Marvin Bautista's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Marvin Bautista enrolled in Medicare?

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

Which organization bills Medicare for Marvin Bautista's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marvin Bautista reassigns Medicare benefits to Bautista Chiropractic Care Inc (San Bruno, CA). 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 Marvin 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 Marvin Bautista was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.