Basic Information
Provider Information | |||||||||
NPI: | 1851387419 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BAUMANN | ||||||||
FirstName: | LOUIS | ||||||||
MiddleName: | R | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 500 STERLING DR | ||||||||
Address2: |   | ||||||||
City: | ORCHARD PARK | ||||||||
State: | NY | ||||||||
PostalCode: | 141271573 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7166772273 | ||||||||
FaxNumber: | 7166772477 | ||||||||
Practice Location | |||||||||
Address1: | 500 STERLING DR | ||||||||
Address2: |   | ||||||||
City: | ORCHARD PARK | ||||||||
State: | NY | ||||||||
PostalCode: | 141271573 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7166772273 | ||||||||
FaxNumber: | 7166772477 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/20/2005 | ||||||||
LastUpdateDate: | 08/13/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 1777792 | NY | Y |   | Allopathic & Osteopathic Physicians | Urology |   |
ID Information
ID | Type | State | Issuer | Description | 1909185 | 01 | NY | INDEPENDENT HEALTH | OTHER | 005113192 | 01 | NY | COMMUNITY BLUE | OTHER | 161511795 | 01 | NY | NOVA | OTHER | 01380703 | 05 | NY |   | MEDICAID | 1099969 | 01 | NY | GHI | OTHER | MD442S | 01 | NY | PREFERRED CARE | OTHER | 00020506401 | 01 | NY | UNIVERA | OTHER | 0443 | 01 | NY | BLUE CROSS ROCHESTER | OTHER | 161511795 | 01 | NY | HUMANA | OTHER | P010117779 | 01 | NY | BLUE CHOICE | OTHER | 161511795 | 01 | NY | NORTH AMERICAN | OTHER | 161511795 | 01 | NY | UNITED HEALTHCARE EMPIRE | OTHER | 340013072 | 01 | NY | RAILROAD MEDICARE | OTHER |