Jeremy Ronald Baker, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

19 Woodland St Ste 23
Hartford, CT 06105-2368

Phone

(860) 522-2251

Fax

(860) 493-2552

NPI assigned

Dec 15, 2019

Last updated

May 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Healthcare, PCGroup PAC ID 6709787930, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johnson Memorial Hospital Hospital, Stafford Springs, CT, CCN 070008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremy.baker.1@31712.direct.athenahealth.com

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.

• Prime Healthcare, PC

  • Internal Medicine Physician
  • Wethersfield, CT
  • NPI 1184819302
  Medicare reassignment Care Compare group NPD
• Waterbury Neurology LLC

  • Neurology Physician
  • Middlebury, CT
  • NPI 1255378501
  NPD

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

• Johnson Memorial Hospital, Inc.

  • Psychiatric Hospital Unit
  • Stafford Springs, CT
  • NPI 1053480293
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1932123569
  Care Compare affiliation
• Johnson Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Stafford Springs, CT
  • NPI 1972728442
  Care Compare affiliation

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

{
    "created_epoch": "1576368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1295373785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 KEARSARGE VALLEY RD",
            "city": "WILMOT",
            "state": "NH",
            "postal_code": "032874706",
            "telephone_number": "603-359-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST STE 23",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052368",
            "telephone_number": "860-522-2251",
            "fax_number": "860-493-2552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Straits Tpke Ste 307",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "CT",
            "postal_code": "067621836",
            "country_code": "US",
            "telephone_number": "203-758-8995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "JEREMY",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-15",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbaker461316@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Prime Healthcare Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "19 Woodland St Ste 23",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061052368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raghubinder K Bajwa, M.D.
• Stephanie L Bakaysa, MD
• Melissa Baker Chalker
• Dana L Baker, RN
• Hope Alicia Baker, RN
• John Baker, MD
• Lisa Susan Baker, APRN
• William Leslie Baker Jr., PHARM.D.
• Seema Prakash Bakhru, MD
• Brenda Estefania Balarezo, RN

• Medical Physician Assistant in Hartford, CT
• Providers in Hartford, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.