Individual provider Active NPI

Paul Mitchell Bauer, MD

  • Trauma Surgery Physician
  • Fort Wayne, IN
National Provider Identifier
1083697874
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
01051916A Issued in IN
Practice address
Lutheran Hospital
7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone
(260) 435-7001
NPI assigned
Nov 25, 2005
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 01051916A IN
Surgical Critical Care Physician 2086S0102X 01051916A IN
Trauma Surgery Physician 2086S0127X 01051916A IN Primary

Addresses

Primary practice location

Lutheran Hospital
7950 W Jefferson Blvd
Fort Wayne, IN 46804

Mailing address

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-7001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, NM, IN, NJ, CA6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20050519000339 PA Practitioner - Critical Care (Intensivists)Practitioner - General SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 3779564802 Reassigns benefits to 2 organizations
I20100813000054 NY Practitioner - General SurgeryPractitioner - General Practice 3779564802 Reassigns benefits to 1 organization
I20130401000195 NM Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3779564802 Reassigns benefits to 2 organizations
I20150731015441 IN Practitioner - General Surgery 3779564802 Reassigns benefits to 1 organization
I20200417002861 NJ Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3779564802
I20220926001471 CA Practitioner - General Surgery 3779564802 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01051916AINMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Hospital Surgery CurrentSince Sep 24, 2018 Accepting new patients
Taos Health Systems Inc Holy Cross Hospital CurrentSince Apr 2, 2024 Accepting new patients
Lancaster General Hospital CurrentSince Sep 24, 2018 Accepting new patients
Harlem Medical Associates PC CurrentSince May 4, 2019 Accepting new patients
Porter Physician Services LLC CurrentSince Oct 24, 2024 Accepting new patients
Lancaster General Hospital CurrentSince Sep 24, 2018 Accepting new patients
Acute Care Surgery Medical Group, Inc. Surgery CurrentSince Sep 12, 2022 Accepting new patients
Lancaster General Hospital Current Accepting new patients
Pecos Valley of New Mexico, LLC CurrentSince Apr 18, 2023 Accepting new patients
Saraswati D. Dayal, MD, LLC Surgery Past Accepting new patients
Porter Physician Services LLC Past Accepting new patients
Acute Care Surgery Medical Group, Inc. Surgery PastSince Jul 2, 2023 Accepting new patients
Advantagehealth Medical Services, PC Past Accepting new patients
Liberty Surgical Associates Surgery Past Accepting new patients
Alliance Health Partners, LLC Past Accepting new patients

Locations

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

150 N Jackson Ave
Ste 100
San Jose, CA 95116
Phone (408) 769-5340

1800 Spring Ridge Dr
Susanville, CA 96130
Phone (530) 252-2225

650 Dickinson Rd
Ste A
Chesterton, IN 46304
Phone (219) 926-2133

650 Dickinson Rd
Ste Z
Chesterton, IN 46304
Phone (219) 464-9507

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

2410 W Pierce St
Carlsbad, NM 88220
Phone (505) 885-0766

2420 W Pierce St
Ste 200
Carlsbad, NM 88220
Phone (505) 885-0600

2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100

1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

555 N Duke St
Lancaster, PA 17602
Phone (717) 544-5945

950 S Octorara Trl
#H
Parkesburg, PA 19365
Phone (717) 544-3737

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1083697874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-435-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LUTHERAN HOSPITAL",
            "address_2": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46804",
            "telephone_number": "260-435-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "PAUL",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2024-03-01",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01051916A",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IN",
            "license": "01051916A",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IN",
            "license": "01051916A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.