Michelle Kathleen Bacares, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

00209508 Issued in NY

Practice address

5 Pine West PLZ Ste 512
Albany, NY 12205-5587

Phone

(518) 650-6674

Fax

(518) 641-1651

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2013 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/10d65d12-0ecf-4613-84df-07c7c4f09ca4/

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.

• Broome County

  • Skilled Nursing Facility
  • Vestal, NY
  • NPI 1750477923
  NPD (past)
• Broome County Mental Health Department

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Binghamton, NY
  • NPI 1629094065
  NPD (past)
• Northeast Psychological Associates

  • Clinical Psychologist
  • Albany, NY
  • NPI 1275751133
  NPD (past)
• Northeast Psychological Associates PLLC

  • Psychologist
  • Albany, NY
  • NPI 1447817093
  NPD (past)
• Warren Washington Association for Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hudson Falls, NY
  • NPI 1073549796
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1477584639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13373",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12212",
            "telephone_number": "518-650-6674",
            "fax_number": "518-641-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PINE WEST PLZ STE 512",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122055587",
            "telephone_number": "518-650-6674",
            "fax_number": "518-641-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACARES",
        "first_name": "MICHELLE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "00209508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP PROVIDER",
            "identifier": "53088A",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000412260001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00209508",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Azuma
• Claudia Ibilola Azuonye, MSN, RN, CNM
• Ryan S Azzam, DO
• B-Logical Administrative Consulting LLC
• Rosemond ABA Yaa Baah
• Brenden Bachus, PA
• Nicole Backlund, FNP
• Omar B Badawy, MD
• Kaushik Bagchi, MD
• Leigh Bagg, PT

• Psychiatry Physician in Albany, NY
• Providers in Albany, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.