NPIMap

Individual provider Active NPI

Levi James Bauer

  • Student in an Organized Health Care Education/Training Program
  • Norfolk, VA
National Provider Identifier
1053024232
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1600 Granby St Apt 460
Norfolk, VA 23510-2662
Phone
(407) 756-5069
NPI assigned
Jan 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0110009378 VA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1600 Granby St Apt 460
Norfolk, VA 23510-2662

Mailing address

1600 Granby St Apt 460
Norfolk, VA 23510-2662
Phone (407) 756-5069

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231012000798 VA Practitioner - Physician Assistant 7911352877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrointestinal Specialists LLCGroup PAC ID 5294797957, 79 clinicians

Practice addresses (Care Compare)

6602 W Broad St
Suite B
Richmond, VA 23230-1702
Phone (804) 285-8206

8266 Atlee Rd
Suite 133
Mechanicsville, VA 23116-1805
Phone (804) 285-8206

Hospital & facility affiliations

  • Bon Secours Memorial Regional Medical Center Hospital, Mechanicsville, VA, CCN 490069
  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118
  • Bon Secours St Marys Hospital Hospital, Richmond, VA, CCN 490059
  • CJW Medical Center Hospital, Richmond, VA, CCN 490112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1053024232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 GRANBY ST APT 460",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102662",
            "telephone_number": "407-756-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 GRANBY ST APT 460",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102662",
            "telephone_number": "407-756-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "LEVI",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0110009378",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.