NPIMap

Individual provider Active NPI

Susan Bauer, D.O.

  • Family Medicine Physician
  • Park Rapids, MN
National Provider Identifier
1891144085
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
65191 Issued in MN
Practice address
705 Pleasant Ave S
Park Rapids, MN 56470-1440
Phone
(218) 732-2800
NPI assigned
Jun 8, 2016
Last updated
May 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R-15-2016 NM
Family Medicine Physician 207Q00000X 65191 MN Primary

Addresses

Primary practice location

705 Pleasant Ave S
Park Rapids, MN 56470-1440

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190522002109 MN Practitioner - Family Practice 0840587903 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Care Medical ServicesGroup PAC ID 3678542842, shared by 6 NPIs, 22 clinicians
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians
Bridges Medical CenterGroup PAC ID 4981659851, 22 clinicians
St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

Practice addresses (Care Compare)

121 Central St W
Bagley, MN 56621-4393
Phone (218) 694-6281

13060 Isle Dr
Baxter, MN 56425-8331
Phone (218) 828-2880

201 9TH St W
Ada, MN 56510-1279
Phone (218) 784-5000

705 Pleasant Ave S
Park Rapids, MN 56470-1440
Phone (218) 732-2800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-15-2016NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Care Medical Services CurrentSince Nov 2, 2020 Accepting new patients
First Care Medical Services CurrentSince Nov 2, 2020 Accepting new patients
Bridges Medical Center CurrentSince Jan 1, 2026 Accepting new patients
St. Joseph's Medical Center CurrentSince Dec 5, 2021 Accepting new patients
First Care Medical Services CurrentSince Jan 1, 2026 Accepting new patients
St Joseph's Medical Center CurrentSince Dec 5, 2021 Accepting new patients
St. Joseph's Medical Center Current Accepting new patients
St Mary's Regional Health Center CurrentSince Jul 13, 2019 Accepting new patients
St. Marys Regional Health Center Current Accepting new patients
St Mary's Regional Health Center CurrentSince Jul 13, 2019 Accepting new patients
St Marys Regional Health Center Past Accepting new patients

Locations

201 9th St W
Ada, MN 56510
Phone (218) 784-2727

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

1027 Washington Ave
Detroit Lakes, MN 56501
Phone (218) 844-2300

900 Hilligoss Blvd SE
Fosston, MN 56542
Phone (218) 435-1133

705 Pleasant Ave S
Park Rapids, MN 56470
Phone (218) 732-2800

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

Organizations & group practices 12

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1891144085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PLEASANT AVE S",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701440",
            "telephone_number": "218-732-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "R-15-2016",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "65191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Rapids, MN

Sources for this page

Verify at the official NPI Registry.