NPIMap

Individual provider Active NPI

John A Baker, M.D.

  • Internal Medicine Physician
  • Twin Falls, ID
National Provider Identifier
1124061262
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M8866 Issued in ID
Practice address
775 Pole Line Rd W
Suite 302
Twin Falls, ID 83301-5814
Phone
(208) 814-8600
Fax
(208) 814-8942
NPI assigned
Jun 14, 2006
Last updated
Dec 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M8866 ID Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X M8866 ID

Addresses

Primary practice location

775 Pole Line Rd W
Suite 302
Twin Falls, ID 83301-5814

Mailing address

PO Box 587
Twin Falls, ID 83303-0587
Phone (208) 814-7400

Other identifiers 2

IdentifierTypeStateIssuer
P00095566OtherIDRR MEDICARE
806703100MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031209000507 ID Practitioner - Internal Medicine 6901702166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

2550 Addison Ave E
Twin Falls, ID 83301-6748

746 N College Rd
Twin Falls, ID 83301-3486

775 Pole Line Rd W
Twin Falls, ID 83301-5814
Phone (208) 814-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M8866IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Clinic LLC Family Medicine CurrentSince Oct 13, 2003 Accepting new patients
Magic Valley Regional Medical Center Past Accepting new patients
Ecg Associates of Jacksonville P a Past Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

2550 Addison Ave E
Ste A
Twin Falls, ID 83301
Phone (208) 814-7700

2550 Addison Ave E
Ste E
Twin Falls, ID 83301
Phone (208) 814-7780

746 N College Rd
Ste D
Twin Falls, ID 83301
Phone (208) 814-7230

775 Pole Line Rd W
Ste 302
Twin Falls, ID 83301
Phone (208) 814-8600

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

Organizations & group practices 4

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

Hospital & facility affiliations 10

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1124061262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833030587",
            "telephone_number": "208-814-7400",
            "fax_number": "208-814-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 POLE LINE RD W",
            "address_2": "SUITE 302",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015814",
            "telephone_number": "208-814-8600",
            "fax_number": "208-814-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M8866",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "ID",
            "license": "M8866",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00095566",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806703100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.