Individual provider Active NPI

Samuel Moroni Bauserman, MD

  • Student in an Organized Health Care Education/Training Program
  • Little Rock, AR
National Provider Identifier
1225977952
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4301 W Markham St # 507
Little Rock, AR 72205-7199
Phone
(501) 686-5270
NPI assigned
Mar 27, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4301 W Markham St # 507
Little Rock, AR 72205-7199

Mailing address

250 Jude CT Apt 103
Fogelsville, PA 18051-7010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1774569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1225977952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 JUDE CT APT 103",
            "city": "FOGELSVILLE",
            "state": "PA",
            "postal_code": "180517010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 507",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057199",
            "telephone_number": "501-686-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUSERMAN",
        "first_name": "SAMUEL",
        "middle_name": "MORONI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-27",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.