Individual provider Active NPI

Andrea Joy Baker, OD

  • Optometrist
  • Wichita, KS
National Provider Identifier
1235102633
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1521 Issued in KS
Practice address
746 N Maize Rd
Wichita, KS 67212
Phone
(316) 721-8877
Fax
(316) 721-6762
NPI assigned
Feb 8, 2006
Last updated
May 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1521 KS Primary

Addresses

Primary practice location

746 N Maize Rd
Wichita, KS 67212

Mailing address

746 N Maize Rd
Wichita, KS 67212
Phone (316) 721-8877

Other identifiers 1

IdentifierTypeStateIssuer
100318430AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20040313000540 KS Practitioner - Optometry 2961391214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smithville Eye Center LLCGroup PAC ID 1254338353, 12 clinicians

Practice addresses (Care Compare)

116 Cedar Ave
Bonner Springs, KS 66012-1016
Phone (913) 422-7781

404 Ames St
Baldwin City, KS 66006-3099
Phone (785) 594-2200

629 W Crawford St
Clay Center, KS 67432-2337

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Smithville Eye Center LLC Optometrist CurrentSince Jun 27, 2017 Accepting new patients
Lawrence Family Vision Clinic P a Optometrist Past Accepting new patients
Kansas Vision Development Center Past Accepting new patients
Eye Care Associates of Wichita, P.a. Optometrist Past Accepting new patients

Locations

404 Ames St
Baldwin City, KS 66006
Phone (785) 594-2200

116 Cedar Ave
Bonner Springs, KS 66012
Phone (913) 422-7781

629 W Crawford St
Clay Center, KS 67432
Phone (785) 632-6100

8305 Melrose Dr
Overland Park, KS 66214

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1235102633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 N MAIZE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-721-8877",
            "fax_number": "316-721-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 N MAIZE RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67212",
            "telephone_number": "316-721-8877",
            "fax_number": "316-721-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "ANDREA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100318430A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.