Catherine M Baer-Mirza, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019266576 Issued in IL

Practice address

2715 N Main St
Rockford, IL 61103-3111

Phone

(815) 964-8713

Fax

(815) 964-3719

NPI assigned

Apr 6, 2006

Last updated

May 14, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rockford Family Dental P.C.

  • General Practice Dentistry
  • Rockford, IL
  • NPI 1386982940
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1134181779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033111",
            "telephone_number": "815-964-8713",
            "fax_number": "815-964-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033111",
            "telephone_number": "815-964-8713",
            "fax_number": "815-964-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAER-MIRZA",
        "first_name": "CATHERINE",
        "middle_name": "M",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019266576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9177538",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Back in Action Holistic Health Center
• Back to You Birth & Postpartum Doulas
• Nabil David Baddour, D.O., MPH
• Hasan Bader, M.D.
• Baer Chiropractic & Wellness Inc.
• Brenda Michelle Baer, DC
• Ashraf Abdurrazagh Baeshu, M.D
• Carter Bagley, MD
• Sina Bahmanyar, MD
• Samir Mohammed Baig, MD

• General Practice Dentistry in Rockford, IL
• Providers in Rockford, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.