Individual provider Active NPI

John Vincent Baka, M.D.

  • Specialist
  • Benton, AR
National Provider Identifier
1083633366
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
E0792 Issued in AR
Practice address
5 Medical Park Dr.- Suite 308
Benton, AR 72015
Phone
(501) 778-1000
Fax
(501) 778-1010
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X E0792 AR Primary

Addresses

Primary practice location

5 Medical Park Dr.- Suite 308
Benton, AR 72015

Mailing address

PO Box 604
Benton, AR 72018-0604
Phone (501) 778-1000

Other identifiers 2

IdentifierTypeStateIssuer
5K157OtherARBCBS
129634001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20110126000100 AR Practitioner - Obstetrics/Gynecology 8224217005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Arkansas College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1220 Military Rd
Benton, AR 72015-2908
Phone (501) 778-1000

Hospital & facility affiliations

  • Saline Memorial Hospital Hospital, Benton, AR, CCN 040084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E0792ARMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
John V. Baka M.D.P.a Specialist CurrentSince Oct 30, 2010 Accepting new patients

Locations

1220 Military Rd
Benton, AR 72015
Phone (501) 778-1000

Organizations & group practices 1

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 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1083633366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720180604",
            "telephone_number": "501-778-1000",
            "fax_number": "501-778-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MEDICAL PARK DR.- SUITE 308",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72015",
            "telephone_number": "501-778-1000",
            "fax_number": "501-778-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKA",
        "first_name": "JOHN",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "E0792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5K157",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129634001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.