Individual provider Active NPI

Heidy Arias Baca, RN

  • Registered Nurse
  • Melville, NY
National Provider Identifier
1356872048
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
720769 Issued in NY
Practice address
400 S Service Rd
Melville, NY 11747-3316
Phone
(631) 439-3091
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 720769 NY Primary

Addresses

Primary practice location

400 S Service Rd
Melville, NY 11747-3316

Mailing address

174 Lincoln Ave
Brentwood, NY 11717-2620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
720769NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1356872048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 LINCOLN AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117172620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S SERVICE RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473316",
            "telephone_number": "631-439-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARIAS BACA",
        "first_name": "HEIDY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "720769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.