Active NPI
Tyler Baldino
- Military Health Care Provider
- Santa Rita, GU
National Provider Identifier
1003371246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- 0102206244
- Practice address
- Naval Base Guam
Eod Mobile Unit 5
Santa Rita, GU 96540 - Phone
- (585) 749-5292
- NPI assigned
- Feb 1, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Undersea and Hyperbaric Medicine (Emergency Medicine) Physician | 207PE0005X | 0102206244 | VA | |
| Military Health Care Provider | 171000000X | 0102206244 | VA | Primary |
Addresses
Primary practice location
Naval Base Guam
Eod Mobile Unit 5
Santa Rita, GU 96540
Mailing address
Eod Mobile Unit 5
Fpo, AP 96540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102206244 | VA | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1003371246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "EOD MOBILE UNIT 5",
"city": "FPO",
"state": "AP",
"postal_code": "96540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL BASE GUAM",
"address_2": "EOD MOBILE UNIT 5",
"city": "SANTA RITA",
"state": "GU",
"postal_code": "96540",
"telephone_number": "585-749-5292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDINO",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-01",
"last_updated": "2021-09-30",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0005X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
"state": "VA",
"license": "0102206244",
"primary": false
},
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "VA",
"license": "0102206244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rita, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.