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ROAN SANTOS BAUTISTA CNP
NPI 1336866995
Nurse Practitioner in Boston, MA

Active since October 25, 2022PECOS Enrolled

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Roan Santos Bautista Cnp NPPES

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

ROAN SANTOS BAUTISTA CNP (NPI 1336866995) is an individual nurse practitioner in Boston, Massachusetts, licensed in Massachusetts (RN273897) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Belmont.

NPPES Registry Identity

NPI1336866995
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameROAN SANTOS BAUTISTACredential: CNP
Location Address55 FRUIT STBoston, MA 02114-2621
Mailing Address6 Fuyat StHudson, MA 01749-1502 · (978) 881-4677
Phone(781) 259-8565
Sole ProprietorYes
Enumeration DateOctober 25, 2022
Last NPPES UpdateJanuary 15, 2025
NPPES CertifiedJanuary 15, 2025
✔ NPI 1336866995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MA · RN273897
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
55 FRUIT ST, Boston, MA 02114
Open in Google Maps ↗

Secondary Practice Location 1

Location 1115 Mill StBelmont, MA 02478-1064 · Phone (617) 855-2360

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roan Santos Bautista Cnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Roan Bautista reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Massachusetts General Physicians Organization Inc
Same address
Dermatology
55 FRUIT ST, BUL 2
Boston, MA 02114
  • Reassigned Medicare billing, Massachusetts enrollment
  • 6,360 clinicians in this Medicare group
NPI 1801874573 (617) 724-0287
The General Hospital Corporation
Same address
General Acute Care Hospital
55 FRUIT ST, BULFINCH 360
Boston, MA 02114
  • Reassigned Medicare billing, Massachusetts enrollment
  • 6,234 clinicians in this Medicare group
NPI 1023049236 (617) 726-2000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

STUTI GIRISH SHROFF MD, MBBS
Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2971
NANCY WANG M.D.
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (017) 724-4000
DR. DUSAN HANIDZIAR M.D., PH.D.
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Suffolk County (617) 726-3030
JOHN JOSEPH DANKO DO
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 726-2000
DR. MICHAEL ANDREW LOBRITZ M.D, PH.D.
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Suffolk County (617) 724-9248
MS. KELLY ELISHA TRECARTIN NP
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Suffolk County (617) 726-7400
JAMIE MARIE ALLEN NP
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 724-4410
DR. DHAVAL SANJEEV KOLTE M.B.B.S., PH.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114
Suffolk County (617) 643-3238

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 Roan Bautista's NPI number?

The NPI number for Roan Bautista is 1336866995. It was assigned to this individual provider in the NPPES registry on October 25, 2022.

Where is Roan Bautista located?

Roan Bautista practices at 55 Fruit St, Boston, MA 02114. The listed phone number is (781) 259-8565.

What is Roan Bautista's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Roan Bautista enrolled in Medicare?

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

Which organizations bill Medicare for Roan Bautista's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roan Bautista reassigns Medicare benefits to 2 organizations: Massachusetts General Physicians Organization Inc (Boston, MA) and The General Hospital Corporation (Boston, MA). Each 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 Roan 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 Roan Bautista was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.