Individual provider Active NPI

Jacob Bauman, MPT

  • Physical Therapist
  • Florissant, MO
National Provider Identifier
1922202647
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2007023383 Issued in MO
Practice address
790 N US Highway 67
Florissant, MO 63031-5108
Phone
(314) 972-1442
Fax
(314) 972-1533
NPI assigned
Jun 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2007023383 MO Primary

Addresses

Primary practice location

790 N US Highway 67
Florissant, MO 63031-5108

Mailing address

13537 Barrett Parkway Dr
Suite 105
Ballwin, MO 63021-5899
Phone (314) 821-9126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828000038 MO Practitioner - Physical Therapist in Private Practice 1456443019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

1832 Wentzville Pkwy
Wentzville, MO 63385-3817
Phone (636) 327-7110

6940 Olive Blvd
Saint Louis, MO 63130-2544
Phone (314) 781-0679

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Physical Therapist CurrentSince Jun 24, 2020 Accepting new patients
Athletico LTD Physical Therapist CurrentSince Jun 24, 2020 Accepting new patients
Athletico LTD Physical Therapist Current Accepting new patients

Locations

600 Oakmont Ln
Ste 600C
Westmont, IL 60559
Phone (630) 575-6250

1355 Maple St
Farmington, MO 63640
Phone (573) 756-9900

790 N Highway 67 St
Florissant, MO 63031
Phone (314) 972-1442

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

951 Waterbury Falls Dr
O Fallon, MO 63368
Phone (636) 336-0300

8622 Olive Blvd
Olivette, MO 63132
Phone (314) 781-0679

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

107 Concord Plaza Shopping Ctr
Saint Louis, MO 63128
Phone (314) 842-2990

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: jacob.bauman.p2@direct.athleticoltd.nextgenshare.com

Organizations & group practices 3

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1922202647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13537 BARRETT PARKWAY DR",
            "address_2": "SUITE 105",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215899",
            "telephone_number": "314-821-9126",
            "fax_number": "314-821-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 N US HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315108",
            "telephone_number": "314-972-1442",
            "fax_number": "314-972-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "JACOB",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2007023383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.