Jerry Bauer, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

036-051192 Issued in IL

Practice address

1875 Dempster St
Ste 605
Park Ridge, IL 60068-1186

Phone

(847) 698-1088

Fax

(847) 698-1087

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 31, 2020 through Dec 31, 2026

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1861490427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST",
            "address_2": "STE 605",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-698-1088",
            "fax_number": "847-698-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST",
            "address_2": "STE 605",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-698-1088",
            "fax_number": "847-698-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036-051192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051192",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deidre Bass, D.O.
• Marla E Bass, DNP
• Stavros Photios Basseas
• Nomundalai Batmunkh, RD, LDN
• Emma Dineen Bauer
• Leah Baumgart, MS, CF-SLP
• Swati Bavisi, RN, MS, CPNP, APN
• Ronna Bayot, PT
• Andrea M. Bazan, M.D.
• Be Well Stay Well Counseling LLC

• Neurological Surgery Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.