Individual provider Active NPI

John J. Baca, DC

  • Chiropractor
  • Chandler, AZ
National Provider Identifier
1013975200
Registry record updated Nov 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AZ5837 Issued in AZ
Practice address
2745 S Alma School Rd
Ste 2
Chandler, AZ 85286-4405
Phone
(480) 413-0586
Fax
(480) 730-0487
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X AZ5837 AZ Primary

Addresses

Primary practice location

2745 S Alma School Rd
Ste 2
Chandler, AZ 85286-4405

Mailing address

2745 S Alma School Rd
Ste 2
Chandler, AZ 85286-4405
Phone (480) 413-0586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060327000794 AZ Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 2860400272 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ5837AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Chiropractic & Rehabilitation Clinics, LLC CurrentSince May 1, 2010 Accepting new patients
Triad Pain Management Group, PLLC CurrentSince Sep 5, 2012 Accepting new patients
South Mountain Surgery Center, LLC PastSince Aug 27, 2018 Accepting new patients

Locations

2745 S Alma School Rd
Ste 2
Chandler, AZ 85286
Phone (480) 413-0586

5331 S Superstition Mountain Dr
#C105
Queen Valley, AZ 85118
Phone (480) 413-0586

4515 S McClintock Dr
Ste 120
Tempe, AZ 85282
Phone (480) 413-0586

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1013975200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 S ALMA SCHOOL RD",
            "address_2": "STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852864405",
            "telephone_number": "480-413-0586",
            "fax_number": "480-730-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 S ALMA SCHOOL RD",
            "address_2": "STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852864405",
            "telephone_number": "480-413-0586",
            "fax_number": "480-730-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "JOHN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "AZ5837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.