Individual provider Active NPI

Sanaa Baker, FAMILY NURSE PRACTIT

  • Family Nurse Practitioner
  • Gallup, NM
National Provider Identifier
1245805761
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F04210106 Issued in NM
Practice address
2111 College Dr
Gallup, NM 87301-5600
Phone
(505) 863-1820
NPI assigned
May 26, 2021
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F04210106 NM Primary

Addresses

Primary practice location

2111 College Dr
Gallup, NM 87301-5600

Mailing address

2111 College Dr
Gallup, NM 87301-5600
Phone (505) 863-1820

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL @rmchcs.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220502000344 AZ Practitioner - Nurse Practitioner 9638566185 Reassigns benefits to 1 organization
Practice locations: Gilbert, AZ

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142-7709
Phone (480) 512-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F04210106NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Primary Care Physicians Arizona LLC CurrentSince Apr 1, 2022 Accepting new patients
Banner Primary Care Physicians Arizona LLC Current Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

155 E Warner Rd
Gilbert, AZ 85296
Phone (480) 649-6600

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142
Phone (480) 512-3700

Organizations & group practices 3

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1245805761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 COLLEGE DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015600",
            "telephone_number": "505-863-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 COLLEGE DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015600",
            "telephone_number": "505-863-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SANAA",
        "name_prefix": "Mrs.",
        "credential": "FAMILY NURSE PRACTIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "F04210106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "@rmchcs.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2111 College Dr",
            "city": "Gallup",
            "state": "NM",
            "country_code": "US",
            "postal_code": "873015600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.