Carley Jean Bacon, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA12540 Issued in TX

Practice address

701 Dellwood St S
Cambridge, MN 55008-1920

Phone

(763) 689-8700

Fax

(763) 688-7941

NPI assigned

Dec 4, 2018

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carley Jean Schwartz Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, MN2 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 2

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

Merit-based Incentive Payment System (MIPS)

Final score

77.11 of 100Reported as group

Quality

63.28

Promoting interoperability

91

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

72.5

Promoting interoperability

100

Improvement activities

40

Cost

77.07

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbacon628543@excellian.direct.allina.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.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group
• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment
• Ear Nose & Throat Specialty Care of Minnesota PA

  dba ENT Specialty Care

  • Otolaryngology Physician
  • St Louis Park, MN
  • NPI 1336175744
  Medicare reassignment
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment
• Allina Health System

  dba Allina Health Coon Rapids Clinic

  • Family Medicine Physician
  • Coon Rapids, MN
  • NPI 1295031649
  NPD
• Allina Health System

  dba Allina Health TeleRheumatology

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1053767897
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD

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

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253
  Care Compare affiliation

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1316417157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166",
            "fax_number": "612-262-9035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DELLWOOD ST S",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081920",
            "telephone_number": "763-689-8700",
            "fax_number": "763-688-7941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8230 Walnut Hill Ln Ste 320",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752314481",
            "country_code": "US",
            "telephone_number": "214-369-5432",
            "fax_number": "214-369-5591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACON",
        "first_name": "CARLEY",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA12540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbacon628543@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/TXT/PDF",
            "address_1": "701 Dellwood St S",
            "city": "Cambridge",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550081920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLEY",
            "last_name": "SCHWARTZ",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgical Physician Assistant in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Surgical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.