Active NPI
Samantha Baca, PSY.D
- Psychologist
- New York, NY
National Provider Identifier
1487264958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 160 W 86TH St
New York, NY 10024-4018 - Phone
- (212) 362-8755
- NPI assigned
- Aug 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
160 W 86TH St
New York, NY 10024-4018
Mailing address
175 W 95TH St Apt 24D
New York, NY 10025-7166
Phone (347) 996-9257
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220922002265 | NY | Order and Referring Only - Clinical Psychologist | 7911382288 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596844800000",
"number": "1487264958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 W 95TH ST APT 24D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100257166",
"telephone_number": "347-996-9257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 W 86TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244018",
"telephone_number": "212-362-8755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACA",
"first_name": "SAMANTHA",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-08",
"last_updated": "2020-08-08",
"certification_date": "2020-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"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 Aug 8, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.