Active NPI
Brian J Bauer, MSN
- Pediatric Nurse Practitioner
- Norman, OK
National Provider Identifier
1083974836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 93020
- Practice address
- 500 E Robinson St
Suite 2600
Norman, OK 73071-6697 - Phone
- (405) 364-6432
- Fax
- (405) 928-7513
- NPI assigned
- May 25, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 93020 | OK | Primary |
Addresses
Primary practice location
500 E Robinson St
Suite 2600
Norman, OK 73071-6697
Mailing address
500 E Robinson St
Suite 2600
Norman, OK 73071-6697
Phone (405) 364-6432
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200436340A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240716001356 | OK | Practitioner - Nurse Practitioner | 5698210581 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shortgrass Community Health Center Inc
Practice addresses (Care Compare)
400 E Sycamore St
Hollis, OK 73550-1436
Phone (580) 688-2800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93020 | OK | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shortgrass Community Health Center, Inc | Current | Accepting new patients | |
| Shortgrass Community Health Center, Inc | Current | Accepting new patients | |
| Summit Medical Center | Past | Accepting new patients |
Locations
101 S Hudson St
Altus, OK 73521
Phone (580) 301-6154
400 E Sycamore St
Hollis, OK 73550
Phone (580) 688-2800
Interoperability endpoints
- brianbauer@schc.secure.relimedsolutions.com
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Altus, OK
- NPI 1982263752
OK
-
- Federally Qualified Health Center (FQHC)
- Hollis, OK
- NPI 1255695201
-
- Clinic Pharmacy
- Hollis, OK
- NPI 1083286975
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1083974836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 E ROBINSON ST",
"address_2": "SUITE 2600",
"city": "NORMAN",
"state": "OK",
"postal_code": "730716697",
"telephone_number": "405-364-6432",
"fax_number": "405-928-7513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E ROBINSON ST",
"address_2": "SUITE 2600",
"city": "NORMAN",
"state": "OK",
"postal_code": "730716697",
"telephone_number": "405-364-6432",
"fax_number": "405-928-7513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "BRIAN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "MSN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-25",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "OK",
"license": "93020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200436340A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Norman, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.