Michaela Charlotte Bailly, PA-C
Individual provider Active NPI Medical Physician Assistant · Los Alamos, NM
NPI 1205565504 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1205565504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA2022-0098 (NM)
- Practice address
- 3917 West Rd Ste a
Los Alamos, NM 87544-2292 - Phone
- (505) 661-8900
- Fax
- (505) 661-8916
- NPI assigned
- Jun 10, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medical Associates of Northern New Mexico
Practice addresses (Care Compare)
3917 W Rd
Suite a
Los Alamos, NM 87544-2292
Phone (505) 661-8900
Hospital & facility affiliations
- Los Alamos Medical Center
- Christus St Vincent Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.11 of 100
- Quality
- 98.94
- Promoting interoperability
- 81
- Improvement activities
- 40
- Cost
- 80.6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221110002721 | NM | Practitioner - Physician Assistant | 1355718925 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates of Northern New Mexico | Current |
Accepting new patients |
Locations
3917 West Rd
Ste A
Los Alamos, NM 87544
Phone (505) 661-8900
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AAGADA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2022-0098 | NM | Yes |
Addresses
Primary practice location
3917 West Rd Ste a
Los Alamos, NM 87544-2292
Mailing address
3917 West Rd Ste a
Los Alamos, NM 87544-2292
Phone (505) 661-8900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA2022-0098 | Other | NM | NEW MEXICO MEDICAL BOARD LICENSE |
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- Margo Baldwin
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- Barbara Ann Barber
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All providers in Los Alamos, NM · Medical Physician Assistant in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.