Individual provider Active NPI

Edward R Bauer, CRNA

  • Certified Registered Nurse Anesthetist
  • Everett, WA
National Provider Identifier
1023038486
Registry record updated Nov 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60408388 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 259-0966
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R031739 ME
Certified Registered Nurse Anesthetist 367500000X AP60408388 WA Primary

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141202001478 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729024955 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R031739MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 27, 2020 Accepting new patients
Paceline Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2016 Accepting new patients
Optum Care Washington PLLC CurrentSince Nov 17, 2014 Accepting new patients
Washington Anesthesia Partners P.C. CurrentSince Oct 1, 2024 Accepting new patients
Salish Sedation Services, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
Optum Care Washington PLLC CurrentSince Nov 17, 2014 Accepting new patients
Mousam Valley Orthopaedics PA Past Accepting new patients
Mainehealth Past Accepting new patients
The Medical Group Department of Goodall Hospital Past Accepting new patients

Locations

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

1135 116th Ave NE
Ste 570
Bellevue, WA 98004
Phone (425) 451-7335

3111 Woburn St
Ste 201
Bellingham, WA 98226
Phone (360) 543-5054

340 Birchwood Ave
Bellingham, WA 98225
Phone (267) 817-8902

2930 Squalicum Pkwy
Ste 202
Bellingham, WA 98225
Phone (360) 734-1420

21600 Highway 99
Ste 260
Edmonds, WA 98026
Phone (425) 774-2650

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

11800 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-4500

501 N 34th St
Ste 101
Seattle, WA 98103
Phone (206) 838-1777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1023038486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-258-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-259-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "EDWARD",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "R031739",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60408388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.