Individual provider Active NPI

Kevin Richard Bauereis, M.D.

  • Anesthesiology Physician
  • Louisville, KY
National Provider Identifier
1134449028
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
48414 Issued in KY
Practice address
530 S Jackson St
Louisville, KY 40202-1675
Phone
(502) 852-1735
Fax
(502) 852-6056
NPI assigned
Jun 2, 2010
Last updated
Jun 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 48414 KY Primary

Addresses

Primary practice location

530 S Jackson St
Louisville, KY 40202-1675

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0328

Other practice location 1

University Of Kentucky & Affiliates
800 Rose Street
Lexington, KY 40536-0001
Phone (859) 323-5871

Other identifiers 2

IdentifierTypeStateIssuer
7100362720MedicaidKY
300039499MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20151006002733 KY Practitioner - Anesthesiology 1951619220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kentucky College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 562-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jul 1, 2020 Accepting new patients
University of Louisville Physicians, Inc. Anesthesiology CurrentSince Jul 1, 2020 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1134449028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0328",
            "fax_number": "502-587-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-1735",
            "fax_number": "502-852-6056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University Of Kentucky & Affiliates",
            "address_2": "800 Rose Street",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360001",
            "country_code": "US",
            "telephone_number": "859-323-5871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUEREIS",
        "first_name": "KEVIN",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-02",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "48414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100362720",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300039499",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.