Active NPI
Jared Bauer, PT, DPT
- Orthopedic Physical Therapist
- Ithaca, NY
National Provider Identifier
1609464528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- Practice address
- 310 Taughannock Blvd
Ithaca, NY 14850-3251 - Phone
- (607) 277-3861
- NPI assigned
- Jan 6, 2021
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | Primary |
Addresses
Primary practice location
310 Taughannock Blvd
Ithaca, NY 14850-3251
Mailing address
310 Taughannock Blvd
Ithaca, NY 14850-3251
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1609464528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 TAUGHANNOCK BLVD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148503251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 TAUGHANNOCK BLVD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148503251",
"telephone_number": "607-277-3861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "JARED",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-06",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.