Troy Robinson Baker, MD
Individual provider Active NPI Family Medicine Physician · Eagle Mountain, UT
NPI 1487624664 · NPPES record last updated May 24, 2021
Key facts
- NPI
- 1487624664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 12177649-1205 (UT)
- Practice address
- 3943 E Pony Express Pkwy
Eagle Mountain, UT 84005-5541 - Phone
- (017) 895-5668
- Fax
- (801) 642-2941
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fallon Medical Complex Inc
Practice addresses (Care Compare)
202 S 4TH St W
Baker, MT 59313-9156
Phone (406) 778-5303
Hospital & facility affiliations
- Fallon Medical Complex Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250507000976 | MT | Practitioner - Family Practice | 5698920593 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12177649-1205 | UT | MD | Family Medicine Physician |
| 25935 | LA | MD | Public Health & General Preventive Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fallon Medical Complex Inc | Current |
Accepting new patients | |
| Fallon Medical Complex Inc | Current |
Accepting new patients | |
| Fallon Medical Complex Inc | Current | Accepting new patients | |
| Fallon Medical Complex Inc | Past | Accepting new patients |
Locations
710 Drake St
Wibaux, MT 59353
Phone (406) 778-2833
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 25935 | LA | |
| Family Medicine Physician | 207Q00000X | MD.025935 | LA | |
| Family Medicine Physician | 207Q00000X | 12177649-1205 | UT | Yes |
Addresses
Primary practice location
3943 E Pony Express Pkwy
Eagle Mountain, UT 84005-5541
Mailing address
830 N 2000 W
Pleasant Grove, UT 84062-4047
Phone (801) 756-3511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61750077 | Medicaid | CO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | PCIS |
Other providers in Eagle Mountain, UT
- Rebecca A Anderson
- Kristine Andrus
- Arcadia Residential Center LLC
- Cally Archibald
- Heather Baker
- Balance Family Solutions LLC
- Richard Allen Baldwin
- Tyler J. Barney
- Janay L Beales
- Leslie Xiomara Behunin
All providers in Eagle Mountain, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.