Shane D Bauer, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5173-024 Issued in WI

Practice address

101 Camelot Dr Ste 4
Fond Du Lac, WI 54935-8048

Phone

(920) 929-9712

NPI assigned

Jan 19, 2006

Last updated

Jul 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical Therapy and Sports Medicine SCGroup PAC ID 2365432903, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Physical Therapy & Sports Medicine SC

  • Physical Medicine & Rehabilitation Physician
  • Appleton, WI
  • NPI 1407857790

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Bauer Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Fond Du Lac, WI
  • NPI 1437271012
  Authorized official Same address or phone
• Advanced Physical Therapy & Sports Medicine SC

  • Durable Medical Equipment & Medical Supplies
  • Grand Chute, WI
  • NPI 1538858857

  Physical Therapist

  NPD

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1144200676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE STE 113",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137862",
            "telephone_number": "920-991-2561",
            "fax_number": "920-560-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CAMELOT DR STE 4",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358048",
            "telephone_number": "920-929-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "SHANE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5173-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40340300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Batzler
• Martha W Bauder, MD
• Bauer Chiropractic, LLC
• Bauer Physical Therapy LLC
• Hattie Rose Bauer
• Shayne Michael Bauer, DC
• Jennifer Nichole Baumeister
• Amy A Bayer, LCSW
• Jennifer Beattie
• April Beck-Jahn

• Physical Therapist in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.