Individual provider Active NPI

Robert Baumgarten, P.T.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Gunnison, CO
National Provider Identifier
1972532208
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
PT210053 Issued in CA
Practice address
405 W Tomichi Ave
Gunnison, CO 81230-2713
Phone
(970) 901-7684
Fax
(510) 704-7765
NPI assigned
Jun 30, 2006
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X PT210053 CA Primary

Addresses

Primary practice location

405 W Tomichi Ave
Gunnison, CO 81230-2713

Mailing address

2999 Regent St
Ste 225
Berkeley, CA 94705-2190
Phone (510) 704-7760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160826001250 CO Practitioner - Physical Therapist in Private Practice 6204835853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

121 W Virginia Ave
Gunnison, CO 81230-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT210053CAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Creek Physical Therapy LLC CurrentSince Jun 1, 2020 Accepting new patients
TSH Inc. PastSince Dec 17, 2012 Accepting new patients

Locations

121 W Virginia Ave
Ste A
Gunnison, CO 81230
Phone (970) 901-7684

405 W Tomichi Ave
Gunnison, CO 81230
Phone (970) 901-7684

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1972532208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2999 REGENT ST",
            "address_2": "STE 225",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052190",
            "telephone_number": "510-704-7760",
            "fax_number": "510-704-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W TOMICHI AVE",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812302713",
            "telephone_number": "970-901-7684",
            "fax_number": "510-704-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARTEN",
        "first_name": "ROBERT",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "PT210053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gunnison, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.