Mary Theresa Bauer, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1498 Issued in OH

Practice address

6701 Rockside Rd
#260
Independence, OH 44131-2358

Phone

(216) 369-2525

Fax

(216) 369-2531

NPI assigned

Oct 12, 2005

Sex

Female

Sole proprietor

No

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919

  OH

  Medicare reassignment
• The Cleveland Clinic Foundation

  • Family Medicine Physician
  • Avon, OH
  • NPI 1184428336
  NPD
• Marymount Primary Care Services Inc

  • Specialist
  • Chagrin Falls, OH
  • NPI 1538183066
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 14, 2009.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1437147402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 ROCKSIDE RD",
            "address_2": "#260",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312358",
            "telephone_number": "216-369-2525",
            "fax_number": "216-369-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 ROCKSIDE RD",
            "address_2": "#260",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312358",
            "telephone_number": "216-369-2525",
            "fax_number": "216-369-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "1498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000493627",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel J. Barther, DDS
• Zachary Barther, DC
• Elissa Kathleen Doering Bartlett
• Rebecca Ann Bartley, MSN, RN, CPNP
• Michelle Marie Nameth Baskin, M.ED., BCBA, COBA
• Olivia Jane Baumann, LPC, M.ED.
• Bayada Home Health Care, Inc.
• Bayada Home Health Care, Inc.
• Linda Baznik
• Parrise Beckley

• All providers in Independence, OH
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.