Individual provider Active NPI

Adam Baker, PA-C

  • Physician Assistant
  • Henderson, NV
National Provider Identifier
1245846187
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2561 Issued in NV
Practice address
2440 W Horizon Ridge Pkwy Ste 130
Henderson, NV 89052-2731
Phone
(800) 640-3451
Fax
(385) 287-1900
NPI assigned
Sep 16, 2020
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2561 NV Primary
Physician Assistant 363A00000X PA2561 ID

Addresses

Primary practice location

2440 W Horizon Ridge Pkwy Ste 130
Henderson, NV 89052-2731

Mailing address

PO Box 1200
Pleasant Grove, UT 84062-1200
Phone (800) 640-3451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NV, ID3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20201113001769 OR Practitioner - Physician Assistant 2264842624 Reassigns benefits to 1 organization
I20220303000837 NV Practitioner - Physician Assistant 2264842624 Reassigns benefits to 1 organization
I20220719002810 ID Practitioner - Physician Assistant 2264842624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

2440 W Horizon Ridge Pkwy
Suite 130
Henderson, NV 89052-2731
Phone (800) 640-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2561IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Family Health Care Inc CurrentSince Oct 21, 2020 Accepting new patients
Valley Family Health Care, Inc CurrentSince Oct 21, 2020 Accepting new patients

Locations

1441 NE 10th Ave
Payette, ID 83661
Phone (208) 642-9376

17 S 3rd St
Nyssa, OR 97913
Phone (541) 372-5738

896 Fortner St
Ontario, OR 97914
Phone (541) 709-2038

789 Washington St W
Vale, OR 97918
Phone (503) 473-2101

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": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1245846187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621200",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 W HORIZON RIDGE PKWY STE 130",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522731",
            "telephone_number": "800-640-3451",
            "fax_number": "385-287-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2561",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA2561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.