DR. PAYTON BAUSMAN (MD) – Family Medicine Physician, NPI 1073194379

DR. PAYTON BAUSMAN (MD) is a healthcare provider. based in Glenwood, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 72040 (MN). The NPI Number for DR. PAYTON BAUSMAN (MD) is 1073194379

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. PAYTON BAUSMAN (MD)
NPI
1073194379
Phone
(320) 634-5157
Address
417 FRANKLIN ST S
Enumeration Date
19 April 2021
Last Update Date
30 July 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
3206345157
Graduation Year
2021 (5 years ago)
PAC ID
0749684579
Group Practice PAC ID
5294789194
Professional Enrollment ID
I20240812002022
Address ID
MN563341518GL417XXSXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Digital endpointsOther names

3,075 FAMILY PRACTICE in MN

Provider Addresses for DR. PAYTON BAUSMAN (MD)

  • 417 FRANKLIN ST S

    GLENWOOD, MN 563341518

    Phone: (320) 634-5157

    Type: Mailing

  • 330 N 8TH AVE E

    DULUTH, MN 558052024

    Phone: (218) 529-9122

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-09-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220907002382IFamily PracticeMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 56334)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294789194View full group profile
NameSpecialtyState
Nurse PractitionerMN
O P T O M E T R YMN
General Practice, Emergency MedicineMN
Ophthalmology, General PracticeMN
Certified Nurse Midwife (Cnm)SD
Physician AssistantMN
Nurse PractitionerMN
O B S T E T R I C S/ G Y N E C O L O G YMN
Diagnostic RadiologyND
Nurse PractitionerSD

Reviews

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Frequently asked questions

What is the registry number for DR. PAYTON BAUSMAN (MD)?
The registry entry for DR. PAYTON BAUSMAN (MD) shows NPI 1073194379.
Does the public listing show DR. PAYTON BAUSMAN (MD) as active?
DR. PAYTON BAUSMAN (MD)'s NPI record reflects an active status in NPPES.
What does the directory say DR. PAYTON BAUSMAN (MD) does?
Insurance directories may phrase it differently, but here DR. PAYTON BAUSMAN (MD) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Can patients visit DR. PAYTON BAUSMAN (MD) in Glenwood, Minnesota?
For routing, start with Glenwood, Minnesota for DR. PAYTON BAUSMAN (MD), then verify phone and hours locally.
Can I export DR. PAYTON BAUSMAN (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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