NPIMap

Organization Active NPI

Baca Community Health

  • Primary Care Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1245995315
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
BACA COMMUNITY HEALTH
Practice address
2921 Carlisle Blvd NE Ste 125
Albuquerque, NM 87110-2865
Phone
(505) 573-2666
NPI assigned
Nov 3, 2021
Last updated
Oct 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Lakeitha C Burton
Title
Revenue Cycle Manager
Phone
(719) 491-8173

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2921 Carlisle Blvd NE Ste 125
Albuquerque, NM 87110-2865

Mailing address

2921 Carlisle Blvd NE Ste 119
Albuquerque, NM 87110-2864
Phone (505) 539-5290

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220106002020 NM Part B Supplier - Clinic/Group Practice 7416348156 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Albuquerque, NM

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Baca Community Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1245995315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 CARLISLE BLVD NE STE 119",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871102864",
            "telephone_number": "505-539-5290",
            "fax_number": "505-212-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 CARLISLE BLVD NE STE 125",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871102865",
            "telephone_number": "505-573-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACA COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "LAKEITHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "719-491-8173"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.