Individual provider Active NPI

Wayne E Bauman, MD

  • Dermatology Physician
  • Cincinnati, OH
National Provider Identifier
1770554602
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35041847B Issued in OH
Practice address
10496 Montgomery Rd
Suite 201
Cincinnati, OH 45242
Phone
(513) 984-5042
Fax
(513) 984-8759
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35041847B OH Primary

Addresses

Primary practice location

10496 Montgomery Rd
Suite 201
Cincinnati, OH 45242

Mailing address

PO Box 428668
Cincinnati, OH 45242-8668
Phone (513) 984-5042

Other identifiers 2

IdentifierTypeStateIssuer
0411932MedicaidOH
791071182OtherOHRR MEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35041847BOHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne E. Bauman, M.D. Dermatology PastSince Dec 31, 1975 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1770554602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428668",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452428668",
            "telephone_number": "513-984-5042",
            "fax_number": "513-984-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10496 MONTGOMERY RD",
            "address_2": "SUITE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-984-5042",
            "fax_number": "513-984-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "WAYNE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35041847B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0411932",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "791071182",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.