Individual provider Active NPI

Matthew Bauer, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1497076004
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1013794 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5724
Phone
(617) 355-6000
NPI assigned
Jun 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1013794 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MA2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220824003861 WA Practitioner - Diagnostic Radiology 3577947589 Reassigns benefits to 3 organizations
I20240611003602 MA Practitioner - Diagnostic Radiology 3577947589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Children'S Hospital Radiology Foundation, Inc.Group PAC ID 6901800861, 58 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724

Hospital & facility affiliations

  • Boston Children'S Hospital Hospital, Boston, MA, CCN 223302

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tra-Minw P S CurrentSince Jul 10, 2022 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Jun 20, 2022 Accepting new patients
Children'S Hospital Radiology Foundation, Inc. Diagnostic Radiology CurrentSince Jul 5, 2024 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Jul 10, 2022 Accepting new patients
Tra-Minw P S CurrentSince Jul 10, 2022 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

6140 E Lake Sammamish Pkwy SE
Ste F
Issaquah, WA 98029

222 15th Ave SE
Puyallup, WA 98372

1304 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 680-3372

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

3402 S 18th St
Tacoma, WA 98405
Phone (253) 383-1099

4525 S 19th St
Tacoma, WA 98405
Phone (253) 759-2622

Interoperability endpoints

  • Direct secure messaging: mbauer36727@direct.bostonchildrens.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1497076004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1013794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.