Bradley R Baker, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

7125T Issued in CA

Practice address

516 Jay St
Colusa, CA 95932-2436

Phone

(530) 458-2020

Fax

(530) 458-8977

NPI assigned

May 24, 2006

Last updated

May 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: 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.

• Colusa Eyecare Optometry

  • Optometrist
  • Colusa, CA
  • NPI 1265770416
  NPD (past) Authorized official
• Colusa Indian Community Council

  • Clinic/Center
  • Colusa, CA
  • NPI 1245709435
  NPD (past)
• Three Rivers Optometric Group Inc

  • Optometrist
  • Yuba City, CA
  • NPI 1497866545
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1154376283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 JAY ST",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959322436",
            "telephone_number": "530-458-2020",
            "fax_number": "530-458-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 JAY ST",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959322436",
            "telephone_number": "530-458-2020",
            "fax_number": "530-458-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "BRADLEY",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7125T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0071250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL GRP #",
            "identifier": "GSD004280",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS GROUP",
            "identifier": "ZZZ07805Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• American Advanced Gastroenterology Inc
• Ampla Health
• Haley Amundson
• Apexcare Medical Transport
• Parveen Kaur Bains, OD
• James Christian Balderama
• Andrea Michelle Balsley, FNP
• James Barrett II, MD
• Kerri A Bartlett, D.O.
• Shaneen W Bayless, MENTAL HEALTH WORKER

• Optometrist in Colusa, CA
• Providers in Colusa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.