Agnes C Bacala, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01043434A Issued in 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

Last updated

Dec 15, 2020By 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 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Louisville Geriatric AssociatesGroup PAC ID 1557380086, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009

Merit-based Incentive Payment System (MIPS)

Final score

99.41 of 100Reported as group

Quality

95.65

Promoting interoperability

100

Improvement activities

40

Cost

69.07

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abacala18677@bhkydirect.com
• Direct secure messaging: agnes.bacala.1@8360.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/8360/brand/1/csg/1/fhir/r4

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.

• Louisville Geriatric Associates

  dba Wall Street Medical Group

  • Internal Medicine Physician
  • Jeffersonville, IN
  • NPI 1922337617
  Medicare reassignment Care Compare group
• Lifespring, Inc

  dba Southern Indiana Mental Health and Guidance Center of ECI

  • Community/Behavioral Health Agency
  • Jeffersonville, IN
  • NPI 1851489942
  Medicare reassignment NPD
• Lifespring, Inc

  dba LifeSpring Health Systems

  • Community/Behavioral Health Agency
  • Dale, IN
  • NPI 1639029283
  NPD
• Community Medical Associates, Inc.

  • Neurological Surgery Physician
  • Louisville, KY
  • NPI 1922288760
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Norton Clark Hospital, LLC

  dba Norton Clark Hospital

  • General Acute Care Hospital
  • Jeffersonville, IN
  • NPI 1134186315
  Care Compare affiliation

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1205891744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475010760",
            "telephone_number": "812-254-2760",
            "fax_number": "812-254-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12546 E US HIGHWAY 50",
            "city": "LOOGOOTEE",
            "state": "IN",
            "postal_code": "475535220",
            "telephone_number": "812-295-5095",
            "fax_number": "812-295-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACALA",
        "first_name": "AGNES",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "32413",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01043434A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200072110",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00298628",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64130602",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - KY",
            "identifier": "P00711471",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abacala18677@bhkydirect.com",
            "affiliation": "N",
            "address_1": "7725 Highway 62 # 110",
            "city": "Charlestown",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471119615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Priya Susan Alex, MD
• Alvarez Vision Services Inc (Alvarez Vision Services PC)
• Michael Manuel Alvarez, O.D.
• Rachel Marie Anderson, PHARM.D.
• Angela B. Smith, D.D.S.
• Jennifer Ann Bailey, CCC-SLP
• Rick D Bauer, O.D.
• Janet L Baugh, NP
• Martha Ann Blackwell, PT
• Kimberly Lane Bowling, BCMT

• Family Medicine Physician in Loogootee, IN
• Providers in Loogootee, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.