Jonathan Glenn Baker, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

8097A Issued in WY

Practice address

984 West Broadway
Suite 4
Jackson, WY 83001-0000

Phone

(307) 734-1800

Fax

(307) 734-5012

NPI assigned

Nov 22, 2005

Last updated

Aug 4, 2014By 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

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Missouri, Columbia School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Teton Dermatology LLCGroup PAC ID 0042335333, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.27 of 100Reported as group

Quality

73.33

Improvement activities

40

Cost

76.45

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonathan.baker@epiphanyderm.emadirect.md

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.

• Teton Dermatology LLC

  • Dermatology Physician
  • Jackson, WY
  • NPI 1194044750
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1447233754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14510",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830024510",
            "telephone_number": "307-734-1800",
            "fax_number": "307-734-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 WEST BROADWAY",
            "address_2": "SUITE 4",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010000",
            "telephone_number": "307-734-1800",
            "fax_number": "307-734-5012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "JONATHAN",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WY",
            "license": "8097A",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A55560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela E Bailey, O.T.R.
• Paul Bailey
• Sharon L Bailey, DNP
• Emily Bain
• Brittany Wilson Baker, MD
• Molly Makela Barber, CCC-SLP
• Jenny Barbera
• Kayla Michelle Barglowski, MSW, PCSW
• Alexandra Barnett, LCSW
• Francine P Bartlett, P.T., A.T.C.

• Dermatology Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• Dermatology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.