Carolyn A. Bauer, PA-C
Individual provider Active NPI Physician Assistant · Santa Fe, NM
NPI 1710137658 · NPPES record last updated Oct 30, 2023
Key facts
- NPI
- 1710137658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA20080043 (NM)
- Practice address
- 1651 Galisteo St Ste 8
Santa Fe, NM 87505-4752 - Phone
- (505) 820-9870
- Fax
- (505) 983-1265
- NPI assigned
- Sep 29, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincent Hospital
Practice addresses (Care Compare)
465 Saint Michaels Dr
Suite 110
Santa Fe, NM 87505-7670
Phone (505) 982-3534
465 Saint Michaels Dr
Suite 230
Santa Fe, NM 87505-8602
Phone (505) 913-4710
Hospital & facility affiliations
- Christus St Vincent Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090430000314 | NM | Practitioner - Physician Assistant | 6305994377 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA20080043 | NM | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Hospital | Current |
Accepting new patients | |
| St Vincent Hospital | Current |
Accepting new patients | |
| St Vincent Hospital | Past | Accepting new patients |
Locations
465 Saint Michaels Dr
Ste 117
Santa Fe, NM 87505
Phone (505) 913-5190
465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901
465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901
455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361
Interoperability endpoints
- cbauer477698@christushealth.direct-ci.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA20080043 | NM | Yes |
Addresses
Primary practice location
1651 Galisteo St Ste 8
Santa Fe, NM 87505-4752
Mailing address
PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 636510AU6T | Other | NM | MEDICARE PTAN |
| 74909754 | Medicaid | NM |
Other providers in Santa Fe, NM
- Jill Lori Basso
- Liv Basso
- Gail M. Bastian
- Amy H Bates
- Alyssa N Bauer
- Joseph Bauer
- Laurie Bauer
- Russell Solo Baum
- Madeline Bauman
- Joan Baumbach
All providers in Santa Fe, NM · Physician Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.