Matthew Bauer, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A157303 Issued in CA

Practice address

BLDG #50, Farenholt Ave
Agana Heights, GU 96910

Phone

(671) 344-9202

NPI assigned

Jun 26, 2017

Last updated

Feb 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GU

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Guam Healthcare Development Incorporated

  dba GRMC Specialty Care Center

  • Clinic/Center
  • Dededo, GU
  • NPI 1326447939
  Medicare reassignment NPD
• NH Guam

  • Military/U.S. Coast Guard Pharmacy
  • Agana Heights, GU
  • NPI 1558214809
  NPD (past)

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1043730542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 TIVOLI ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG #50, FARENHOLT AVE",
            "city": "AGANA HEIGHTS",
            "state": "GU",
            "postal_code": "96910",
            "telephone_number": "671-344-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A157303",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GU",
            "license": "M-2273",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VAD0000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Custodio Arevalo, MSN/ED, RN, AMB-BC
• Jessica Arrott
• Yosselin Arroyo-Galvan, M.D
• Daisy Rose Leones Baisa, RN
• Makala Marie Bascome, DO
• Thomas C Baugh, D.O.
• Lovelle L Baza, LCSW
• Maya Naima Bell, M.ED, OTD, OTR/L
• Kimberly Boyd
• Nicholas John Brandes, PA

• Internal Medicine Physician in Agana Heights, GU
• Providers in Agana Heights, GU by specialty
• Internal Medicine Physician in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.