Active NPI
Edward D Bayer, MD
- Pediatrics Physician
- De Pere, WI
National Provider Identifier
1891789657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 38740
- Practice address
- 1716 Lawrence Dr
De Pere, WI 54115-9108 - Phone
- (920) 605-3115
- Fax
- (920) 486-6826
- NPI assigned
- Sep 8, 2005
- Last updated
- Sep 18, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 38740 | WI | Primary |
Addresses
Primary practice location
1716 Lawrence Dr
De Pere, WI 54115-9108
Mailing address
1716 Lawrence Dr
De Pere, WI 54115-9108
Phone (920) 605-3115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38740 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Gianna Molla Clinic, Inc | Current | Accepting new patients | |
| Ear Nose & Throat Surgical Associates SC | Past | Accepting new patients |
Locations
1716 Lawrence Dr
De Pere, WI 54115
Phone (920) 605-3115
1716 Lawrence Dr
#100
De Pere, WI 54115
Phone (920) 605-3115
Interoperability endpoints
- edward.bayer.1@25400.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- De Pere, WI
- NPI 1104426477
-
- Specialist
- Appleton, WI
- NPI 1629094214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1891789657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1716 LAWRENCE DR",
"city": "DE PERE",
"state": "WI",
"postal_code": "541159108",
"telephone_number": "920-605-3115",
"fax_number": "920-486-6826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 LAWRENCE DR",
"city": "DE PERE",
"state": "WI",
"postal_code": "541159108",
"telephone_number": "920-605-3115",
"fax_number": "920-486-6826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAYER",
"first_name": "EDWARD",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "38740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Pere, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.