Individual provider Active NPI

Krista C Bauder

  • Medical Physician Assistant
  • Saint Paul, NE
National Provider Identifier
1962936880
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2118 Issued in NE
Practice address
1113 Sherman St
Saint Paul, NE 68873-1546
Phone
(308) 754-5447
Fax
(308) 754-5449
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2118 NE Primary

Addresses

Primary practice location

1113 Sherman St
Saint Paul, NE 68873-1546

Mailing address

1113 Sherman St
Saint Paul, NE 68873-1546
Phone (308) 754-5447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170427000104 NE Practitioner - Physician Assistant 9335426428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Nebraska Orthopedics and Sports Medicine PCGroup PAC ID 8123077518, 13 clinicians

Practice addresses (Care Compare)

2620 W Faidley Ave
Grand Island, NE 68803-4205
Phone (308) 384-4600

620 N Diers Ave
Grand Island, NE 68803-4984
Phone (308) 384-5400

620 N Diers Ave
Suite 200
Grand Island, NE 68803-4985

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Foot & Ankle Clinic of Central Nebraska PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: krista.bauder.p1@direct.cnorthopedics.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1962936880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 SHERMAN ST",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688731546",
            "telephone_number": "308-754-5447",
            "fax_number": "308-754-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 SHERMAN ST",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688731546",
            "telephone_number": "308-754-5447",
            "fax_number": "308-754-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUDER",
        "first_name": "KRISTA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "2118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, NE

Sources for this page

Verify at the official NPI Registry.