Individual provider Active NPI

Laurel A Bauer, MD

  • Gynecology Physician
  • Beverly, MA
National Provider Identifier
1174555155
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
72149 Issued in MA
Practice address
83 Herrick Street
Suite 2004
Beverly, MA 01915
Phone
(978) 927-4800
Fax
(978) 232-5772
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 72149 MA Primary

Addresses

Primary practice location

83 Herrick Street
Suite 2004
Beverly, MA 01915

Mailing address

83 Herrick Street
Suite 2004
Beverly, MA 01915
Phone (978) 927-4800

Other identifiers 1

IdentifierTypeStateIssuer
3063135MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050406000143 MA Practitioner - Obstetrics/Gynecology 5698722288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
State University of New York at Buffalo School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essex County OBGYN Assoc IncGroup PAC ID 6204829062, 26 clinicians

Practice addresses (Care Compare)

480 Maple St
Suite 3
Danvers, MA 01923-4067
Phone (978) 927-4800

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72149MAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Essex County OBGYN Assoc Inc CurrentSince Apr 6, 1990 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. Past Accepting new patients

Locations

83 Herrick St
Ste 2004
Beverly, MA 01915
Phone (978) 927-4800

83 Herrick St
Ste 3002
Beverly, MA 01915
Phone (978) 750-8300

480 Maple St
Ste 303
Danvers, MA 01923

140 Commonwealth Ave
Ste 208
Danvers, MA 01923
Phone (978) 232-5538

480 Maple St
Ste 3
Danvers, MA 01923
Phone (978) 927-4800

Interoperability endpoints

  • Direct secure messaging: lbauer27607@direct.bilh.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1174555155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 HERRICK STREET",
            "address_2": "SUITE 2004",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-927-4800",
            "fax_number": "978-232-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 HERRICK STREET",
            "address_2": "SUITE 2004",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-927-4800",
            "fax_number": "978-232-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "LAUREL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MA",
            "license": "72149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3063135",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.