Individual provider Active NPI

Charles Jeffrey Baus, O.D.

  • Optometrist
  • Palm Desert, CA
National Provider Identifier
1215911565
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12183T Issued in CA
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

Updated by the provider on Aug 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
GSD004460OtherCAMEDICAID GROUP NUMBER
ZZZ24908ZOtherCAMEDICARE GROUP NUMBER
SD0121830MedicaidCA
0313520001OtherCADMERC 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080114000863 CA Practitioner - Optometry 8426139676 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
12183TCAMDOptometrist
OPT12183CAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles J Baus, OD an Optometric Corporation Optometrist CurrentSince Mar 30, 2016 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.

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

Verify at the official NPI Registry.