Individual provider Active NPI

Gary W. Bauerle, M.D.

  • Vascular & Interventional Radiology Physician
  • Denver, CO
National Provider Identifier
1033129267
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
29487 Issued in CO
Practice address
938 Bannock St
Ste 300
Denver, CO 80204-4028
Phone
(303) 914-8800
Fax
(303) 716-3777
NPI assigned
Aug 9, 2006
Last updated
Sep 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 29487 CO Primary

Addresses

Primary practice location

938 Bannock St
Ste 300
Denver, CO 80204-4028

Mailing address

938 Bannock St
Ste 300
Denver, CO 80204
Phone (303) 914-8800

Other identifiers 1

IdentifierTypeStateIssuer
01294875MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041028000386 CO Practitioner - Diagnostic Radiology 9830151216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29487COMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greeley Xray Group PC Past Accepting new patients
Flatirons Radiology, LLC Vascular & Interventional Radiology Past Accepting new patients
Sterling Regional Medcenter Past Accepting new patients
Diversified Radiology of Colorado, Inc Past Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1033129267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 BANNOCK ST",
            "address_2": "STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80204",
            "telephone_number": "303-914-8800",
            "fax_number": "303-716-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 BANNOCK ST",
            "address_2": "STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044028",
            "telephone_number": "303-914-8800",
            "fax_number": "303-716-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUERLE",
        "first_name": "GARY",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CO",
            "license": "29487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01294875",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.