Individual provider Active NPI

Derek Baker

  • Certified Registered Nurse Anesthetist
  • Clinton Township, MI
National Provider Identifier
1508337197
Registry record updated Dec 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704293006 Issued in MI
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2715
NPI assigned
Dec 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704293006 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

5767 Shannon LN
Clarkston, MI 48348-5168
Phone (248) 535-8644

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190327002500 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537409693 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester Medical Associates PLLCGroup PAC ID 8729318704, 23 clinicians

Practice addresses (Care Compare)

1349 S Rochester Rd
Suite 150
Rochester Hills, MI 48307-3152
Phone (248) 844-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation Nurse Anesthetist, Certified Registered CurrentSince Feb 18, 2019 Accepting new patients
Macomb Anesthesia, PC CurrentSince Sep 1, 2019 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Sep 9, 2019 Accepting new patients
Rochester Medical Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 18, 2020 Accepting new patients
Henry Ford Health System CurrentSince Feb 1, 2020 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Feb 18, 2019 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2020 Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

43475 Dalcoma Dr
Ste 100
Clinton Twp, MI 48038
Phone (586) 263-5043

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

1349 S Rochester Rd
Ste 150
Rochester Hills, MI 48307
Phone (248) 844-3800

Interoperability endpoints

  • Direct secure messaging: dbaker556394@direct.hfhs.org

Organizations & group practices 7

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": "1544227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544227200000",
    "number": "1508337197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 SHANNON LN",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485168",
            "telephone_number": "248-535-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-08",
        "last_updated": "2018-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704293006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.