Benjamin D Bauer, MD
Individual provider Active NPI Pediatrics Physician · Indianapolis, IN
NPI 1295743086 · NPPES record last updated Mar 28, 2011
Key facts
- NPI
- 1295743086
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 01062493A (IN)
- Practice address
- 705 Riley Hospital Dr
Ste 1721
Indianapolis, IN 46202-5109 - Phone
- (317) 962-8067
- Fax
- (317) 962-3796
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01062493A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital & Regional Medical Center 2 | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01062493A | IN | |
| Pediatrics Physician | 208000000X | 01062493A | IN | Yes |
Addresses
Primary practice location
705 Riley Hospital Dr
Ste 1721
Indianapolis, IN 46202-5109
Mailing address
PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 274-1201
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295743086 | Medicaid | MI | |
| 200828830 | Medicaid | IN |
Other providers in Indianapolis, IN
- Gillian Battung
- Abdulrahman Noor a Batwa
- Rebecca Elaine Baud
- Brianna Bauer-Nordness
- Angela R Bauer
- Donna Bauer
- Matthew James Bauer
- Sarah E. Bauer
- Sarah Jo Bauer
- Vickie Bauer
All providers in Indianapolis, IN · Pediatrics Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.