Active NPI
Charles Jeffrey Baus, O.D.
- Optometrist
- Palm Desert, CA
National Provider Identifier
1215911565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 12183T
- Practice address
- 72608 El Paseo
Suite 6
Palm Desert, CA 92260-3373 - Phone
- (760) 776-9767
- Fax
- (760) 776-9333
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | OPT12183 | CA | |
| Optometrist | 152W00000X | 12183T | CA | Primary |
Addresses
Primary practice location
72608 El Paseo
Suite 6
Palm Desert, CA 92260-3373
Mailing address
72608 El Paseo
Suite 6
Palm Desert, CA 92260-3373
Phone (760) 776-9767
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GSD004460 | Other | CA | MEDICAID GROUP NUMBER |
| ZZZ24908Z | Other | CA | MEDICARE GROUP NUMBER |
| SD0121830 | Medicaid | CA | |
| 0313520001 | Other | CA | DMERC M/C REGION D |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
72608 El Paseo
Suite 6
Palm Desert, CA 92260-3373
Phone (760) 776-9767
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12183T | CA | MD | Optometrist |
| OPT12183 | CA | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles J Baus, OD an Optometric Corporation | Optometrist | Current | Accepting new patients |
Locations
72608 El Paseo
Ste 6
Palm Desert, CA 92260
Phone (760) 776-9767
Organizations & group practices 1
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.
-
- Optometrist
- Palm Desert, CA
- NPI 1720456288
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408924800000",
"number": "1215911565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72608 EL PASEO",
"address_2": "SUITE 6",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603373",
"telephone_number": "760-776-9767",
"fax_number": "760-776-9333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72608 EL PASEO",
"address_2": "SUITE 6",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922603373",
"telephone_number": "760-776-9767",
"fax_number": "760-776-9333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUS",
"first_name": "CHARLES",
"middle_name": "JEFFREY",
"name_prefix": "Mr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-30",
"last_updated": "2014-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CA",
"license": "OPT12183",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "12183T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID GROUP NUMBER",
"identifier": "GSD004460",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "ZZZ24908Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0121830",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC M/C REGION D",
"identifier": "0313520001",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.