Larry L Baker, M.D., D.D.S.
Individual provider Active NPI Oral & Maxillofacial Surgery (D.M.D.) · Hastings, NE
NPI 1508967639 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1508967639
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.) 204E00000X
- License
- 22775 (NE)
- Practice address
- 501 W 9TH St
Hastings, NE 68901-3908 - Phone
- (402) 463-3088
- Fax
- (402) 463-3099
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Maxillofacial Surgery
- Education
- Mayo Medical School, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
501 W 9TH St
Hastings, NE 68901-3908
Phone (402) 463-3088
Hospital & facility affiliations
- Mary Lanning Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
- 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 |
|---|---|---|---|---|
| I20041217000706 | NE | Practitioner - Maxillofacial Surgery |
3971594201 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22775 | NE | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Larry L Baker, MD, DDS, PC | Oral & Maxillofacial Surgery | Current |
Accepting new patients |
| Hastings Surgical Center, LLC | Current | Accepting new patients |
Locations
501 W 9th St
Hastings, NE 68901
Phone (402) 463-3088
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 22775 | NE | Yes |
Addresses
Primary practice location
501 W 9TH St
Hastings, NE 68901-3908
Mailing address
PO Box 947
Hastings, NE 68902-0947
Phone (402) 463-3088
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025150000 | Medicaid | NE |
Other providers in Hastings, NE
- Della L Bader
- Linda K Bahe
- Dagne D Bajo
- Elizabeth Baker
- Jason Ray Baker
- Zachary Baker
- Larina Renee Ballheim
- Valentina Barclay
- Charlotte M Barrientez
- Gary W Barth
All providers in Hastings, NE · Oral & Maxillofacial Surgery (D.M.D.) in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.