Benjamin Bauer, MA
Individual provider Active NPI Mental Health Counselor · Otsego, MN
NPI 1104459312 · NPPES record last updated Feb 16, 2020
Key facts
- NPI
- 1104459312
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 9245 Quantrelle Ave
Otsego, MN 55330 - Phone
- (763) 746-9492
- NPI assigned
- Feb 16, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nystrom and Associates LTD
Practice addresses (Care Compare)
9245 Quantrelle Ave NE
Otsego, MN 55330-0168
Phone (763) 746-9492
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240417001075 | MN | Practitioner - Mental Health Counselor | 0446699953 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3548 | MN | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Support Services Inc. | Mental Health | Current |
Accepting new patients |
| Nystrom & Associates, LTD | Current |
Accepting new patients |
Locations
9245 Quantrelle Ave NE
Otsego, MN 55330
Phone (763) 308-8619
1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
9245 Quantrelle Ave
Otsego, MN 55330
Mailing address
1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Other providers in Otsego, MN
- Kevin Alan Augustin
- Avalyn Care LLC
- Rebecca L Bachmeier
- Ciera Renee Bacon
- Margaret Bailey
- Julie Beaufeaux
- Evan Bedore
- Michaela Bellefy
- Brianna Lynn Benson
- Brooke Kathleen Benson
All providers in Otsego, MN · Mental Health Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.