Individual provider Active NPI

Baba Sy

  • Chore Provider
  • Anchorage, AK
National Provider Identifier
1417389511
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chore ProviderTaxonomy code 372500000X
Practice address
3760 W 74TH Ave
Anchorage, AK 99502-2862
Phone
(907) 350-0061
Fax
(907) 868-1592
NPI assigned
Jul 31, 2013
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 978570 AK
Chore Provider 372500000X AK Primary

Addresses

Primary practice location

3760 W 74TH Ave
Anchorage, AK 99502-2862

Mailing address

2025 E 73Rd Ave Apt 1
Anchorage, AK 99507-2789
Phone (907) 222-6855

Other practice location 1

2025 E 73rd Ave Apt 1
Anchorage, AK 99507-2789
Phone (907) 222-6855

Other identifiers 1

IdentifierTypeStateIssuer
1417389511MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Baba@dabakh.directak.net.directak.net

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

State licenses

LicenseStateTypeSpecialty
978570AKMDAdult Development & Aging Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dabakh Assisted Living Home CurrentSince Jul 27, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: baba@dabakh.directak.net.directak.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1417389511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 E 73RD AVE APT 1",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995072789",
            "telephone_number": "907-222-6855",
            "fax_number": "907-222-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 W 74TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995022862",
            "telephone_number": "907-350-0061",
            "fax_number": "907-868-1592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 E 73rd Ave Apt 1",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995072789",
            "country_code": "US",
            "telephone_number": "907-222-6855",
            "fax_number": "907-222-2653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SY",
        "first_name": "BABA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-31",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "AK",
            "license": "978570",
            "primary": false
        },
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417389511",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Baba@dabakh.directak.net.directak.net",
            "affiliation": "N",
            "address_1": "3760 W 74th Ave",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995022862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.