Agnes C Bacala, M.D.
Individual provider Active NPI Family Medicine Physician · Loogootee, IN
NPI 1205891744 · NPPES record last updated Dec 15, 2020
Key facts
- NPI
- 1205891744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01043434A (IN)
- Practice address
- 12546 E US Highway 50
Loogootee, IN 47553-5220 - Phone
- (812) 295-5095
- Fax
- (812) 295-9403
- NPI assigned
- Apr 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Louisville Geriatric Associates
Practice addresses (Care Compare)
443 Spring St
Suite 200
Jeffersonville, IN 47130-4494
Phone (812) 288-8360
Hospital & facility affiliations
- Norton Clark Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.41 of 100
- Quality
- 95.65
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.07
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060131000220 | IN | Practitioner - Family Practice | 7517971419 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespring, Inc | Current |
Accepting new patients | |
| Lifespring, Inc | Current |
Accepting new patients | |
| Community Medical Associates, Inc. | Past | Accepting new patients |
Locations
460 Spring St
Jeffersonvlle, IN 47130
Phone (812) 280-3583
1321 S Jackson St
Salem, IN 47167
Phone (812) 883-3095
Interoperability endpoints
- agnes.bacala.1@8360.direct.athenahealth.com
- https://api.platform.athenahealth.com/8360/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 32413 | KY | |
| Family Medicine Physician | 207Q00000X | 01043434A | IN | Yes |
Addresses
Primary practice location
12546 E US Highway 50
Loogootee, IN 47553-5220
Mailing address
PO Box 760
Washington, IN 47501-0760
Phone (812) 254-2760
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00711471 | Other | KY | RAILROAD MEDICARE - KY |
| P00298628 | Other | IN | RAILROAD MEDICARE |
| 200072110 | Medicaid | IN | |
| 64130602 | Medicaid | KY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | abacala18677@bhkydirect.com |
Other providers in Loogootee, IN
- Priya Susan Alex
- Alvarez Vision Services Inc
- Michael Manuel Alvarez
- Rachel Marie Anderson
- Angela B. Smith, D.D.S.
- Jennifer Ann Bailey
- Rick D Bauer
- Janet L Baugh
- Martha Ann Blackwell
- Kimberly Lane Bowling
All providers in Loogootee, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2020. 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.