Individual provider Active NPI

Aimee L Baek, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Phoenix, AZ
National Provider Identifier
1497061386
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
47730 Issued in AZ
Practice address
4212 N 16TH St
Phoenix, AZ 85016-5319
Phone
(602) 263-1200
NPI assigned
Aug 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 47730 AZ Primary
Family Medicine Physician 207Q00000X A113695 CA

Addresses

Primary practice location

4212 N 16TH St
Phoenix, AZ 85016-5319

Mailing address

4212 N 16TH St
Phoenix, AZ 85016-5319
Phone (602) 263-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20170815002564 TX Practitioner - Family Practice 5698952398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Icahn School of Medicine at Mount Sinai, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dhew Ind HLTH SV HLTH SVS and MNTL HLTH AdmGroup PAC ID 1759290901, 219 clinicians

Practice addresses (Care Compare)

4212 N 16TH St
Phoenix, AZ 85016-5319
Phone (602) 263-1200

Hospital & facility affiliations

  • Phoenix Indian Medical Center Hospital, Phoenix, AZ, CCN 030078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47730AZMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jul 23, 2017 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jul 23, 2017 Accepting new patients

Locations

2121 W Reservation Loop Rd
Camp Verde, AZ 86322
Phone (929) 567-2168

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

Organizations & group practices 2

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": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497061386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-263-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEK",
        "first_name": "AIMEE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "47730",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A113695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.