Active NPI
Matthew Thomas Bauer, O.D.
- Optometrist
- Saint Paul, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3168
- Practice address
- 401 Phalen Blvd
Saint Paul, MN 55130-5302 - Phone
- (651) 254-7500
- Fax
- (651) 254-7557
- NPI assigned
- Jul 24, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3168 | MN | Primary |
Addresses
Primary practice location
401 Phalen Blvd
Saint Paul, MN 55130-5302
Mailing address
8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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
- New England College of Optometry, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Visionworks Inc | Past | Accepting new patients | |
| Vision World Inc | Past | Accepting new patients |
Locations
300 Lake Dr E
Chanhassen, MN 55317
Phone (952) 993-4300
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870
Organizations & group practices 4
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.
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- Minneapolis, MN
- NPI 1710924683
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- NPI 1952042053
-
- Eyewear Supplier
- Fergus Falls, MN
- NPI 1982789533
-
- Eyewear Supplier
- Omaha, NE
- NPI 1205924792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615248000000",
"number": "1316177348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S # MS 21110Q",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 PHALEN BLVD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551305302",
"telephone_number": "651-254-7500",
"fax_number": "651-254-7557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-24",
"last_updated": "2021-03-09",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MN",
"license": "3168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.