Individual provider Active NPI

Rakesh Baboo, MD, MBBS

  • Internal Medicine Physician
  • Stockton, CA
National Provider Identifier
1083190839
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A173931 Issued in CA
Practice address
3132 W March LN Ste 5
Stockton, CA 95219-2354
Phone
(209) 475-5500
Fax
(209) 475-5535
NPI assigned
Jul 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A173931 CA Primary

Addresses

Primary practice location

3132 W March LN Ste 5
Stockton, CA 95219-2354

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210729001596 CA Practitioner - Internal Medicine 8628322575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

3132 W March LN
Suite 5
Stockton, CA 95219-2354
Phone (209) 475-5500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A173931CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Aug 2, 2021 Accepting new patients
Dignity Health Medical Foundation CurrentSince Aug 2, 2021 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Port City Operating Company, LLC Past Accepting new patients
St Joseph Regional Health Network Past Accepting new patients

Locations

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3132 W March Ln
Ste 5
Stockton, CA 95219
Phone (209) 475-5500

1901 N California St
Stockton, CA 95204
Phone (209) 946-6800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1083190839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 W MARCH LN STE 5",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192354",
            "telephone_number": "209-475-5500",
            "fax_number": "209-475-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABOO",
        "first_name": "RAKESH",
        "credential": "MD, MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A173931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.