Micah S. Bautista, RDN
NPI 1164175063ActiveIndividual· Dietitian, Registered· Modesto, CA
Dietitian, Registered (RDN) in Modesto, California, licensed in CA, with an NPI issued in January 2022. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1164175063 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RDN |
| Sole proprietor | No |
| NPI issued | Jan 31, 2022 |
| Last updated in NPPES | Feb 7, 2023 |
| Certified by provider | Feb 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 86289720 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (CA) |
|---|
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