NPIMap

Individual provider Active NPI

Raymond T Bauer, MD

  • Physical Medicine & Rehabilitation Physician
  • St Clair Shores, MI
National Provider Identifier
1083607691
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301062448 Issued in MI
Practice address
25311 Little Mack Ave
Suite B
St Clair Shores, MI 48081-3370
Phone
(586) 498-2400
Fax
(586) 498-2800
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301062448 MI Primary

Addresses

Primary practice location

25311 Little Mack Ave
Suite B
St Clair Shores, MI 48081-3370

Mailing address

8301 Reliable Parkway
Chicago, IL 60686-0083
Phone (586) 498-2400

Other identifiers 1

IdentifierTypeStateIssuer
1083607691MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040329001545 MI Practitioner - Physical Medicine and Rehabilitation 7810887072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Wayne State University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Great Lakes Physiatrists PC 16 clinicians

Practice addresses (Care Compare)

25311 Little Mack Ave
Suite B
Saint Clair Shores, MI 48081-3301
Phone 5864982400111

Hospital & facility affiliations

  • Compassus Home Health Home health agency, Warren, MI, CCN 237081
  • Residential Home Health Home health agency, Troy, MI, CCN 237459
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • Ascension St John Hospital Inpatient rehabilitation facility, Detroit, MI, CCN 23T165

Merit-based Incentive Payment System (MIPS)

Final score
94.92 of 100Reported as group
Quality
93.88
Improvement activities
40
Cost
69.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301062448MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Physiatrists PC Physical Medicine & Rehabilitation CurrentSince Apr 4, 1988 Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients

Locations

8301 Reliable Pkwy
Chicago, IL 60686

5669 Lakeshore Rd
Fort Gratiot, MI 48059
Phone (810) 385-7260

50505 Schoenherr Rd
Ste 200
Shelby Township, MI 48315
Phone (586) 803-1220

50505 Schoenherr Rd
Ste 210
Shelby Township, MI 48315
Phone (586) 884-6681

22700 Greater Mack Ave
St Clair Shrs, MI 48080
Phone (586) 443-4910

25311 Little Mack Ave
Ste B
St Clr Shores, MI 48081
Phone (586) 498-2400

Interoperability endpoints

  • Direct secure messaging: rbauer1116651@direct.hfhs.org
  • Direct secure messaging: raymond.bauer@glp.eclinicaldirectplus.com

Organizations & group practices 2

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 11

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1083607691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 RELIABLE PARKWAY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860083",
            "telephone_number": "586-498-2400",
            "fax_number": "586-498-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25311 LITTLE MACK AVE",
            "address_2": "SUITE B",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813370",
            "telephone_number": "586-498-2400",
            "fax_number": "586-498-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "RAYMOND",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301062448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083607691",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.