NPIMap

Individual provider Active NPI

Nikolas Devenderan Baksh, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Long Beach, CA
National Provider Identifier
1306232467
Registry record updated Oct 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A205026 Issued in CA
Practice address
1201 E Bixby Rd
Long Beach, CA 90807-4221
Phone
(310) 337-2589
NPI assigned
Apr 15, 2015
Last updated
Oct 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X A205026 CA Primary

Addresses

Primary practice location

1201 E Bixby Rd
Long Beach, CA 90807-4221

Mailing address

1201 E Bixby Rd
Long Beach, CA 90807-4221
Phone (310) 337-2589

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nbaksh163138@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220802003173 IL Practitioner - Orthopedic Surgery 7618286261 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr John Attenello MD ApcGroup PAC ID 5294173761, shared by 2 NPIs, 2 clinicians
Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

1201 E Bixby Rd
Long Beach, CA 90807-4221
Phone (310) 337-2589

6425 Cermak Rd
Suite 101
Berwyn, IL 60402-4602
Phone (708) 484-0444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion71
Laminectomy or laminotomy (partial removal of spine bones)46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jul 20, 2022 Accepting new patients
Loyola University Medical Center CurrentSince Jul 20, 2022 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

6800 N Frontage Rd
Burr Ridge, IL 60527
Phone (708) 327-1000

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Interoperability endpoints

  • Direct secure messaging: nbaksh163138@direct.luhs.org

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793145600000",
    "number": "1306232467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 E BIXBY RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074221",
            "telephone_number": "310-337-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E BIXBY RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074221",
            "telephone_number": "310-337-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKSH",
        "first_name": "NIKOLAS",
        "middle_name": "DEVENDERAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A205026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nbaksh163138@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.