Individual provider Active NPI

Nicole M Baca, MD

  • Pediatric Hematology & Oncology Physician
  • West Hollywood, CA
National Provider Identifier
1093077802
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
A136037 Issued in CA
Practice address
8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone
(310) 423-4471
Fax
(310) 423-0145
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A136037 CA
Pediatric Hematology & Oncology Physician 2080P0207X A136037 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
West Hollywood, CA 90048-1804

Mailing address

PO Box 512717
Los Angeles, CA 90051-0717

Other practice location 1

2040 W Charleston Blvd Ste 504
Las Vegas, NV 89102-2207
Phone (702) 671-6437

Other practice location 2

1201 W La Veta Ave
Orange, CA 92868-4203
Phone (714) 509-4348

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
I20190221002238 CA Practitioner - Pediatric Medicine 0941433239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A136037CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Dec 10, 2018 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 18, 2021 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Nov 18, 2021 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Dec 10, 2018 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

8700 Beverly Blvd
Ste AC106
West Hollywood, CA 90048

Interoperability endpoints

  • Direct secure messaging: nbaca221225@direct.cshs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1093077802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512717",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-4471",
            "fax_number": "310-423-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 W Charleston Blvd Ste 504",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022207",
            "country_code": "US",
            "telephone_number": "702-671-6437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 W La Veta Ave",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684203",
            "country_code": "US",
            "telephone_number": "714-509-4348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACA",
        "first_name": "NICOLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A136037",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "CA",
            "license": "A136037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.