Individual provider Active NPI

Antonio Baca, M.D.

  • Emergency Medicine Physician
  • Woodbridge, VA
National Provider Identifier
1043486236
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101250082 Issued in VA
Practice address
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone
(216) 288-1596
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101250082 VA Primary

Addresses

Primary practice location

2300 Opitz Blvd
Woodbridge, VA 22191-3311

Mailing address

5705 Fairfax Dr
Arlington, VA 22205-2305
Phone (216) 288-1596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190503000151 TX Practitioner - Emergency Medicine 3870765134 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pearsall Emergency Medicine Associates, PAGroup PAC ID 1557623147, 45 clinicians

Practice addresses (Care Compare)

11274 McCombs St
El Paso, TX 79934-3455
Phone (915) 242-2400

Hospital & facility affiliations

  • The Hospitals of Providence Horizon City Campus Hospital, Horizon City, TX, CCN 670124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pearsall Emergency Medicine Associates, PA Emergency Medicine CurrentSince Mar 29, 2019 Accepting new patients
Hospitalist Medicine Physicians of Texas - Houston, PLLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Ehra Medical Services of Virginia, PC Emergency Medicine Past Accepting new patients
VA-I Medical Services PC Past Accepting new patients
Bestpractices, Inc. Emergency Medicine Past Accepting new patients

Locations

11274 McCombs St
El Paso, TX 79934
Phone (915) 242-2400

1890 George Dieter Dr
El Paso, TX 79936
Phone (915) 219-9404

13600 Horizon Blvd
Ste 100
Horizon City, TX 79928
Phone (915) 407-7878

3640 Hampton Dr
Missouri City, TX 77459
Phone (281) 778-5144

Interoperability endpoints

  • Direct secure messaging: antonio.baca.1@14718.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1043486236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 FAIRFAX DR",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222052305",
            "telephone_number": "216-288-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913311",
            "telephone_number": "216-288-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101250082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.