Individual provider Active NPI

Vanessa Diane Baracaldo

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1447678388
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
289397 Issued in NY
Practice address
3332 Broadway
New York, NY 10031-8732
Phone
(212) 694-2000
NPI assigned
Mar 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 289397 NY Primary

Addresses

Primary practice location

3332 Broadway
New York, NY 10031-8732

Mailing address

3332 Broadway
New York, NY 10031-8732
Phone (212) 694-2000

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
289397NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vanessabaracaldo@mai.allscriptsdirect.net
  • Direct secure messaging: vanessa.baracaldo.1@20670.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1447678388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3332 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100318732",
            "telephone_number": "212-694-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100318732",
            "telephone_number": "212-694-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARACALDO",
        "first_name": "VANESSA",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-28",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "289397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.