NPIMap

Individual provider Active NPI

Steven J Bauer, MD

  • Psychiatry Physician
  • Duluth, MN
National Provider Identifier
1811921596
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35013 Issued in MN
Practice address
1406 E 2ND St
Duluth, MN 55805-2378
Phone
(218) 728-4491
Fax
(218) 728-7970
NPI assigned
Jul 10, 2006
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 56436-20 WI
Psychiatry Physician 2084P0800X 35013 MN Primary

Addresses

Primary practice location

1406 E 2ND St
Duluth, MN 55805-2378

Mailing address

1401 E 1St St
Duluth, MN 55805-2407
Phone (218) 728-4491

Other practice location 1

1401 E 1st St
Duluth, MN 55805-2407
Phone (218) 728-4491

Other identifiers 1

IdentifierTypeStateIssuer
528595000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080129000743 MN Practitioner - Psychiatry 8123100187 Reassigns benefits to 1 organization
I20150205001968 WI Practitioner - Psychiatry 8123100187

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brightwater Health Dba Human Development Center CurrentSince Nov 1, 2020 Accepting new patients
Brightwater Health Dba Human Development Center Past Accepting new patients
Northwood Children's Home Society Inc Past Accepting new patients
Brightwater Health Dba Human Development Center Past Accepting new patients
Northwood Children's Home Society Inc Past Accepting new patients
Northwood Children's Home Society Inc Past Accepting new patients
Northwood Children's Services, Inc. Past Accepting new patients

Locations

1401 E 1st St
Duluth, MN 55805
Phone (218) 728-4491

1500 N 34th St
Ste 100
Superior, WI 54880
Phone (715) 392-8216

1500 N 34th St
Ste 200
Superior, WI 54880
Phone (715) 392-8216

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1811921596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-728-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052378",
            "telephone_number": "218-728-4491",
            "fax_number": "218-728-7970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052407",
            "country_code": "US",
            "telephone_number": "218-728-4491",
            "fax_number": "218-728-4404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "56436-20",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "35013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528595000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.