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DR. MARYSE EMMERENCIA BAKOUETILA MD
NPI 1871084632
Family Medicine in Irving, TX

Active since May 28, 2018PECOS Enrolled
2021 N MACARTHUR BLVD STE 350, IRVING, TX 75061(972) 817-1600 Get Directions Write a Review

NPPES record last updated: November 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Maryse Emmerencia Bakouetila Md NPPES

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

DR. MARYSE EMMERENCIA BAKOUETILA MD (NPI 1871084632) is an individual family medicine provider in Irving, Texas, licensed in Texas (T3586) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1871084632
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARYSE EMMERENCIA BAKOUETILACredential: MD
Location Address2021 N MACARTHUR BLVD STE 350Irving, TX 75061-2217
Mailing Address10902 Shettleston DrRichmond, TX 77407-2809 · (936) 649-2520
Phone(972) 817-1600
Sole ProprietorNo
Enumeration DateMay 28, 2018
Last NPPES UpdateNovember 17, 2021
NPPES CertifiedNovember 17, 2021
✔ NPI 1871084632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · T3586
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.
2021 N MACARTHUR BLVD STE 350, Irving, TX 75061
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Maryse Emmerencia Bakouetila Md 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 Reassignment

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

Healthtexas Provider Network
11 mi
Anesthesiology
3600 GASTON AVE STE 550
Dallas, TX 75246
  • Reassigned Medicare billing, Texas enrollment
  • 3,167 clinicians in this Medicare group
NPI 1174416689 (214) 821-1177

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 75061 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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 2

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

JENNIFER YVETTE MOREIRA MD
Family Medicine
2021 N MACARTHUR BLVD STE 350
IRVING, TX 75061
Dallas County (972) 817-1600
MRS. NATALYA PRUDEN FNP-C
Clinical Nurse Specialist (Family Health)
2021 N MACARTHUR BLVD STE 350
IRVING, TX 75061
Dallas County (972) 253-2515

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 Maryse Bakouetila's NPI number?

The NPI number for Maryse Bakouetila is 1871084632. It was assigned to this individual provider in the NPPES registry on May 28, 2018.

Where is Maryse Bakouetila located?

Maryse Bakouetila practices at 2021 N Macarthur Blvd Ste 350, Irving, TX 75061. The listed phone number is (972) 817-1600.

What is Maryse Bakouetila's specialty?

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

Is Maryse Bakouetila enrolled in Medicare?

Yes. Maryse Bakouetila is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Maryse Bakouetila's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maryse Bakouetila reassigns Medicare benefits to Healthtexas Provider Network (Dallas, TX). 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 Maryse Bakouetila's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Maryse Bakouetila accept?

Health plans from Blue Cross and Blue Shield of Texas list Maryse Bakouetila 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 Maryse Bakouetila was last updated on November 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.