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NICHOLAS BAUDER APN
NPI 1275216699
Nurse Practitioner - Family in Maryville, IL

Active since August 11, 2023PECOS Enrolled
2148 VADALABENE DR, MARYVILLE, IL 62062(618) 877-4420 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 18, 2025, Aug 11, 2023 (2 updates tracked since 2023).

About Nicholas Bauder Apn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICHOLAS BAUDER APN (NPI 1275216699) is an individual family provider in Maryville, Illinois, licensed in Illinois (209.032488) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Saint Louis, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1275216699
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameNICHOLAS BAUDERCredential: APN
Location Address2148 VADALABENE DRMaryville, IL 62062-5632
Mailing Address1003 Martin Luther King DrBloomington, IL 61701-1429 · (888) 924-3786
Phone(618) 877-4420
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateAugust 11, 2023
Last NPPES UpdateJune 18, 20252 updates tracked since enumeration
NPPES CertifiedJune 18, 2025
✔ NPI 1275216699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.032488
Also ListedRegistered NurseTaxonomy 163W00000X · License 2019043435 (MO), 041476077 (IL)
2148 VADALABENE DR, Maryville, IL 62062
Open in Google Maps ↗

Secondary Practice Location 1

Location 11 Barnes Jewish Hospital PlzSaint Louis, MO 63110-1003 · Phone (314) 747-3000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicholas Bauder Apn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5698271617
PECOS Enrollment IDI20250930001202
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS VICTORIA ANN LISTON BSW, CADC
Social Worker
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 288-3100
CHESTNUT HEALTH SYSTEMS, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 288-3100
CHESTNUT HEALTH SYSTEMS INC.
Substance Abuse Rehabilitation Facility
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 877-4420
MRS. REBECCA LEIGH SALAH MA, LCPC
Counselor (Addiction (Substance Use Disorder))
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 288-3100
CHESTNUT HEALTH SYSTEMS, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 877-4420
MR. KOLIN SMITH B.S. CADC
Counselor (Addiction (Substance Use Disorder))
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 288-3100
MS. JAMIE LEE GARMAN BA,CARS
Counselor (Addiction (Substance Use Disorder))
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 288-3100
MRS. AMY D MORBY L.C.S.W.
Social Worker (Clinical)
2148 VADALABENE DR
MARYVILLE, IL 62062
Madison County (618) 288-3100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Bauder's NPI number?

The NPI number for Nicholas Bauder is 1275216699. It was assigned to this individual provider in the NPPES registry on August 11, 2023.

Where is Nicholas Bauder located?

Nicholas Bauder practices at 2148 Vadalabene Dr, Maryville, IL 62062. The listed phone number is (618) 877-4420.

What is Nicholas Bauder's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Nicholas Bauder enrolled in Medicare?

Yes. Nicholas Bauder is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicholas Bauder was last updated on June 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.