Individual provider Active NPI

Thomas Bauman

  • Emergency Medicine Physician
  • Canton, TX
National Provider Identifier
1942734413
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S8000 Issued in TX
Practice address
18780 Interstate 20
Canton, TX 75103-3593
Phone
(903) 567-7748
Fax
(903) 606-4905
NPI assigned
Apr 12, 2017
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00000 IL
Emergency Medicine Physician 207P00000X S8000 TX Primary

Addresses

Primary practice location

18780 Interstate 20
Canton, TX 75103-3593

Mailing address

3900 W 7TH St
Apt 18
Fort Worth, TX 76107-2519
Phone (612) 251-8761

Other practice location 1

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2109

Other identifiers 2

IdentifierTypeStateIssuer
P02569495OtherTXMEDICARE RAILROAD
P02569453OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200924000689 TX Practitioner - Emergency Medicine 1951675420 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-0111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000ILMDEmergency Medicine Physician
S8000TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Jun 1, 2021 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Nov 1, 2020 Accepting new patients
Mother Frances Hospital Jacksonville CurrentSince Nov 1, 2020 Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

2400 N Interstate Highway 35 E
Waxahachie, TX 75165
Phone (469) 843-4000

Interoperability endpoints

  • Direct secure messaging: tbauman235354@christushealth.direct-ci.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1942734413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W 7TH ST",
            "address_2": "APT 18",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072519",
            "telephone_number": "612-251-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18780 INTERSTATE 20",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751033593",
            "telephone_number": "903-567-7748",
            "fax_number": "903-606-4905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-2109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "00000",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S8000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P02569495",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P02569453",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, TX

Sources for this page

Verify at the official NPI Registry.