NPIMap

Organization Active NPI

Charles J Baus, OD an Optometric Corporation

  • Optometrist
  • Palm Desert, CA
National Provider Identifier
1720456288
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12183 TLG Issued in CA
Legal business name
CHARLES J BAUS, OD AN OPTOMETRIC CORPORATION
Doing business as
Advanced Optometry
Practice address
72608 El Paseo
Suite 6
Palm Desert, CA 92260-3373
Phone
(760) 776-9767
NPI assigned
Sep 14, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Dr. Charles J Baus, ODNPI 1215911565
Title
President
Phone
(760) 776-9767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 12183 TLG CA Primary

Addresses

Primary practice location

72608 El Paseo
Suite 6
Palm Desert, CA 92260-3373

Mailing address

72608 El Paseo
Suite 6
Palm Desert, CA 92260-3373
Phone (760) 776-9767

Other names 1

  • Advanced Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160420001697 CA Part B Supplier - Clinic/Group Practice 3779881974 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Desert, CA

National Provider Directory

National Provider Directory

Locations

72608 El Paseo
Ste 6
Palm Desert, CA 92260
Phone (760) 776-9767

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1720456288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72608 EL PASEO",
            "address_2": "SUITE 6",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603373",
            "telephone_number": "760-776-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72608 EL PASEO",
            "address_2": "SUITE 6",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603373",
            "telephone_number": "760-776-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J BAUS, OD AN OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "BAUS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-776-9767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12183 TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.