GITA BARUAH MD
NPI 1154486223
Physical Medicine & Rehabilitation in Milwaukee, WI

NPI Status: Active since December 27, 2006

Contact Information

945 N 12TH ST
MILWAUKEE, WI
ZIP 53233
Phone: (414) 219-3031
Fax: (414) 219-7731

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  • Individual
  • Female
  • Years of Experience 53
  • Physical Medicine & Rehabilitation
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About GITA BARUAH

This page provides the complete NPI Profile along with additional information for Gita Baruah, a provider established in Milwaukee, Wisconsin with a medical specialization in Physical Medicine & Rehabilitation and more than 53 years of experience. The healthcare provider is registered in the NPI registry with number 1154486223 assigned on December 2006. The practitioner's primary taxonomy code is 208100000X with license number 24088-020 (WI). The provider is registered as an individual and her NPI record was last updated 5 years ago.

NPI
1154486223
Provider Name
GITA BARUAH MD
Gender
Female
Entity Type
Individual
Location Address
945 N 12TH ST MILWAUKEE, WI 53233
Location Phone
(414) 219-3031
Location Fax
(414) 219-7731
Mailing Address
945 N 12TH ST MILWAUKEE, WI 53233
Mailing Phone
(414) 219-3031
Mailing Fax
(414) 219-7731
Medical School Name
OTHER
Graduation Year
1973
Is Sole Proprietor?
No
Enumeration Date
12-27-2006
Last Update Date
11-22-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation

Taxonomy Code
208100000X
Type
Allopathic & Osteopathic Physicians
License No.
24088-020
License State
WI
Taxonomy Description
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • HMO Bronze $0 Medical Deductible - HMO
  • HMO Bronze 10000 - HMO
  • HMO Bronze 7500 - HMO
  • HMO Catastrophic 10600 with 3 free PCP visits - HMO
  • HMO Gold 2000 - HMO
  • HMO Gold 2700 - HMO
  • HMO HDHP Silver 5900 - HMO
  • HMO Silver 6000 - HMO
  • HMO Silver 6600 - HMO
  • POS Bronze 7500 - POS
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • Oak $1,300 Gold - PPO
  • Oak $2,000 Standard Gold - PPO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
30483600MEDICAID (05)WI 

Medicare Participation & PECOS Enrollment Status

Gita Baruah is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Gita Baruah is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 9931174760

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040830000804

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Wheelchairs (DD021N)

    Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each (HCPCS:E0955)

    2 DME suppliers used 24 Medicare Claims 24 Services Paid

  • DME-Wheelchairs (DD021N)

    Manual wheelchair accessory, anti-tipping device, each (HCPCS:E0971)

    2 DME suppliers used 15 Medicare Claims 30 Services Paid

  • DME-Wheelchairs (DD021N)

    Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each (HCPCS:E0973)

    2 DME suppliers used 18 Medicare Claims 35 Services Paid

  • DME-Wheelchairs (DD021N)

    Wheelchair accessory, positioning belt/safety belt/pelvic strap, each (HCPCS:E0978)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Wheelchairs (DD021N)

    Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory (HCPCS:E1028)

    2 DME suppliers used 53 Medicare Claims 53 Services Paid

  • DME-Wheelchairs (DD000N)

    Manual adult size wheelchair, includes tilt in space (HCPCS:E1161)

    2 DME suppliers used 20 Medicare Claims 20 Services Paid

  • DME-Wheelchairs (DD000N)

    Lightweight wheelchair (HCPCS:K0003)

    1 DME suppliers used 16 Medicare Claims 16 Services Paid

  • DME-Wheelchairs (DD000N)

    High strength, lightweight wheelchair (HCPCS:K0004)

    2 DME suppliers used 68 Medicare Claims 68 Services Paid

  • DME-Wheelchairs (DD009N)

    Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds (HCPCS:K0823)

    1 DME suppliers used 14 Medicare Claims 14 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 13 times for 13 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 101 times for 30 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 22 times for 21 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 16 times for 15 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 31 times for 31 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 15 times for 13 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 42 times for 42 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Gita Baruah is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
AURORA ST LUKES MEDICAL CENTER2900 W OKLAHOMA AVE
MILWAUKEE, WI 53215
(414) 649-6000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1154486223, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
8
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
2
Unchanged
Pos 9
2
Doubled → 4
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 4 → 8 6 → 12 → 3 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 0 + 4 + 8 + 8 + 1 + 2 + 2 + 4 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1154486223.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Emergency Medicine
945 N 12TH ST, EMERGENCY MEDICINE
MILWAUKEE, WI 53233
Physician Assistant
945 N 12TH ST
MILWAUKEE, WI 53233
Nurse Practitioner
945 N 12TH ST, EMERGENCY MED
MILWAUKEE, WI 53233
Emergency Medicine
945 N 12TH ST
MILWAUKEE, WI 53233
Emergency Medicine
945 N 12TH ST, EMERGENCY MED
MILWAUKEE, WI 53233
Anesthesiology
945 N 12TH ST, SUITE 3858
MILWAUKEE, WI 53233
Anesthesiology
945 N 12TH ST, SUITE 3858
MILWAUKEE, WI 53233
General Acute Care Hospital
945 N 12TH ST
MILWAUKEE, WI 53233
Anesthesiology
945 N 12TH ST, SUITE 3858
MILWAUKEE, WI 53233
Radiology (Diagnostic Radiology)
945 N 12TH ST, RADIOLOGY
MILWAUKEE, WI 53233
Radiology (Diagnostic Radiology)
945 N 12TH ST, RADIOLOGY
MILWAUKEE, WI 53233
Physician Assistant (Medical)
945 N 12TH ST, SUITE 4602
MILWAUKEE, WI 53233
Emergency Medicine
945 N 12TH ST, EMERGENCY MEDICINE
MILWAUKEE, WI 53233
Emergency Medicine
945 N 12TH ST
MILWAUKEE, WI 53233
Nurse Practitioner
945 N 12TH ST
MILWAUKEE, WI 53233
Nurse Anesthetist, Certified Registered
945 N 12TH ST
MILWAUKEE, WI 53233
Nurse Practitioner
945 N 12TH ST
MILWAUKEE, WI 53233
Dietitian, Registered
945 N 12TH ST, A320
MILWAUKEE, WI 53233
Dietitian, Registered
945 N 12TH ST, A320
MILWAUKEE, WI 53233
Dietitian, Registered
945 N 12TH ST
MILWAUKEE, WI 53233

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154486223, enumerated as an "individual" on December 27, 2006.

The provider is located at 945 N 12TH ST MILWAUKEE, WI 53233 and the phone number is (414) 219-3031.

Physical Medicine & Rehabilitation with taxonomy code 208100000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.

Gita Baruah is affiliated with: AURORA ST LUKES MEDICAL CENTER.