Individual provider Active NPI

Ryan Bauer, O.D.

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1457589368
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2718 Issued in CO
Practice address
3625 Star Ranch Rd
Colorado Springs, CO 80906-5980
Phone
(719) 394-3939
Fax
(719) 394-3939
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2718 CO Primary

Addresses

Primary practice location

3625 Star Ranch Rd
Colorado Springs, CO 80906-5980

Mailing address

3625 Star Ranch Rd
Colorado Springs, CO 80906-5980
Phone (719) 394-3939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20101014000961 CO Practitioner - Optometry 9931391521 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bauer Eyecare PLLCGroup PAC ID 0749618544, 2 clinicians

Practice addresses (Care Compare)

3625 Star Ranch Rd
Colorado Springs, CO 80906-5980
Phone 71939439392003

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2718COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Archdale Eyecare PLLC Optometrist CurrentSince Sep 15, 2010 Accepting new patients
Archdale Optometry Corporation PLLC Optometrist CurrentSince Jul 11, 2010 Accepting new patients
Bauer Eyecare PLLC Optometrist CurrentSince Feb 6, 2020 Accepting new patients
Oneopto Co 1 PLLC Optometrist PastSince Jul 11, 2010 Accepting new patients

Locations

3625 Star Ranch Rd
Colorado Springs, CO 80906
Phone (719) 394-3939

1541 S 8th St
Colorado Springs, CO 80905
Phone (719) 577-4400

7095 Lexington Dr
Colorado Springs, CO 80918
Phone (719) 638-4010

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.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1457589368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 STAR RANCH RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809065980",
            "telephone_number": "719-394-3939",
            "fax_number": "719-394-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 STAR RANCH RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809065980",
            "telephone_number": "719-394-3939",
            "fax_number": "719-394-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.