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DAN F BAUTISTA MD LLC
NPI 1295953933
Family Medicine in Fairborn, OH

Active since April 20, 2007CLIA 36D0952421 · Waiver
1840 COMMERCE CENTER BLVD, FAIRBORN, OH 45324(937) 754-4580(937) 754-4575 Get Directions Write a Review

NPPES record last updated: September 20, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dan F Bautista Md Llc NPPES

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

DAN F BAUTISTA MD LLC (NPI 1295953933) is a healthcare organization registered as a family medicine in Fairborn, Ohio and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through March 2, 2027 and lists Dan Bautista, Owner, as its authorized official.

NPPES Registry Identity

NPI1295953933
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDAN F BAUTISTA MD LLC
Location Address1840 COMMERCE CENTER BLVDFairborn, OH 45324-6337
Mailing Address1840 Commerce Center BlvdFairborn, OH 45324-6337 · (937) 754-4580 · Fax (937) 754-4575
Phone(937) 754-4580
Fax(937) 754-4575
Organization SubpartNo
Authorized OfficialDan BautistaOwner · (937) 754-4580
Enumeration DateApril 20, 2007
Last NPPES UpdateSeptember 20, 2023
NPPES CertifiedSeptember 20, 2023
✔ NPI 1295953933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35073682B
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1840 COMMERCE CENTER BLVD, Fairborn, OH 45324
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Other Identifiers 2

Medicaid2080233OH
Medicaid2871969OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dan F Bautista Md Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Dan F Bautista MD LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dan Bautista, M.D.
Family Practice
NPI 1629006903
1840 COMMERCE CENTER BLVD
Fairborn, OH 45324
(937) 754-4580
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D0952421

Dan F Bautista MD · Fairborn, OH
Active · expires Mar 2, 2027
CLIA Number36D0952421
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2025
Certificate Expiration DateMarch 2, 2027
Laboratory DirectorDan F. Bautista MD
Laboratory Phone(937) 754-4580
Laboratory LocationDan F Bautista MD1840 Commerce Center Boulevard, Fairborn, OH 45324
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Dan F Bautista MD LLC's NPI number?

The NPI number for Dan F Bautista MD LLC is 1295953933. It was assigned to this organization in the NPPES registry on April 20, 2007.

Where is Dan F Bautista MD LLC located?

Dan F Bautista MD LLC is located at 1840 Commerce Center Blvd, Fairborn, OH 45324. The listed phone number is (937) 754-4580.

What is Dan F Bautista MD LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Dan F Bautista MD LLC enrolled in Medicare?

Yes. Dan F Bautista MD LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dan F Bautista MD LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Dan F Bautista MD LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dan F Bautista MD LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0952421) is associated with this NPI, valid through March 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dan F Bautista MD LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Dan F Bautista MD LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dan F Bautista MD LLC was last updated on September 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.