Individual provider Active NPI

Andrew Richard Bauder, MD

  • Surgery of the Hand (Plastic Surgery) Physician
  • San Diego, CA
National Provider Identifier
1720433428
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X
License
A182692 Issued in CA
Practice address
34800 Bob Wilson Dr Ste 1
San Diego, CA 92134-5127
Phone
(619) 532-6950
NPI assigned
May 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X A182692 CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr Ste 1
San Diego, CA 92134-5127

Mailing address

34800 Bob Wilson Dr Ste 1
San Diego, CA 92134-1001
Phone (619) 532-6950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240515000706 CA Practitioner - Plastic and Reconstructive Surgery 0345681805 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Plastic and Cosmetic Surgery IncGroup PAC ID 0749369247, 2 clinicians
Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

6610 Flanders Dr
Suite 101
San Diego, CA 92121-3940
Phone (858) 457-2888

7901 Frost St
San Diego, CA 92123-2701
Phone (858) 939-3400

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A182692CAMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation Multi-Specialty CurrentSince Jun 18, 2024 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Multi-Specialty CurrentSince May 1, 2024 Accepting new patients
Innovative Plastic & Cosmetic Surgery Inc Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Multi-Specialty CurrentSince May 1, 2024 Accepting new patients
Sharp Coronado Hospital and Healthcare Center Past Accepting new patients
Sharp Rees-Stealy Medical Center Multi-Specialty Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

6610 Flanders Dr
Ste 101
San Diego, CA 92121
Phone (858) 457-2888

10670 Wexford St
San Diego, CA 92131
Phone (858) 621-4010

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340

Organizations & group practices 7

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 2

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": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1720433428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341001",
            "telephone_number": "619-532-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR STE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345127",
            "telephone_number": "619-532-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUDER",
        "first_name": "ANDREW",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-01",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "CA",
            "license": "A182692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.