Andre Barranda Bautista, M.D.
NPI 1164665444ActiveIndividual· Radiology, Vascular & Interventional Radiology· Tacoma, WA
Radiology, Vascular & Interventional Radiology (M.D.) with Tra-Minw P S and 1 other group, practicing in Tacoma, Washington. Medicare paid $39,814 for services to 1,054 patients in 2024. Penumbra, Inc. reported $32.50 in payments in 2025, mostly food and beverage. Lists Multicare Good Samaritan Hospital and 4 other hospitals as hospital affiliations.
Overview
| NPI | 1164665444 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | Apr 15, 2009 |
| Last updated in NPPES | Oct 4, 2024 |
| Certified by provider | Oct 4, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Vascular & Interventional Radiology Primary | 2085R0204X | MD60545139 | WA |
| Radiology, Diagnostic Radiology | 2085R0202X | MD60545139 | WA |
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 - Diagnostic Radiology (OR); Practitioner - Diagnostic Radiology (WA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 1,054 |
|---|---|
| Services billed | 1,815 across 129 procedure codes |
| Paid by Medicare | $39,814 |
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Diagnostic Radiology |
| Secondary specialties | Interventional Radiology |
Medical groups
- Tra-Minw P SDecatur, GA · 155 clinicians
- Medical Imaging Northwest - Good Samaritan Hospital Imaging AllianceDecatur, GA · 118 clinicians
Hospital affiliations
- Multicare Good Samaritan HospitalPuyallup, WA
- St Anthony HospitalGig Harbor, WA
- St Clare HospitalLakewood, WA
- St Joseph Medical CenterTacoma, WA
- Tacoma General Allenmore HospitalTacoma, WA
Industry payments (Open Payments)
- 2025$32.50 · 1 payment from 1 company
- 2024$210.53 · 2 payments from 2 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Penumbra, Inc. | $32.50 | 1 |
What the 2025 payments were for
- Food and Beverage$32.50 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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