Individual provider Active NPI

Timothy J Bauer, OD

  • Optometrist
  • Basalt, CO
National Provider Identifier
1215014204
Registry record updated Apr 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1545 Issued in CO
Practice address
850 E Valley Rd
Basalt, CO 81621-7600
Phone
(970) 925-2020
Fax
(970) 927-2010
NPI assigned
Nov 1, 2006
Last updated
Apr 26, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1545 CO Primary

Addresses

Primary practice location

850 E Valley Rd
Basalt, CO 81621-7600

Mailing address

850 E Valley Rd
Basalt, CO 81621-7600
Phone (970) 925-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050902000240 CO Practitioner - Optometry 8426080177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roaring Fork Vision PLLCGroup PAC ID 5092104273, 2 clinicians

Practice addresses (Care Compare)

341 Market St
Basalt, CO 81621-7409
Phone (970) 927-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1545COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roaring Fork Vision PLLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Barthramod Inc Optometrist Past Accepting new patients

Locations

341 Market St
Basalt, CO 81621
Phone (303) 915-4543

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430006400000",
    "number": "1215014204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 E VALLEY RD",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816217600",
            "telephone_number": "970-925-2020",
            "fax_number": "970-927-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E VALLEY RD",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816217600",
            "telephone_number": "970-925-2020",
            "fax_number": "970-927-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Basalt, CO

Sources for this page

Verify at the official NPI Registry.