Individual provider Active NPI

Erik Baish, PA-C

  • Physician Assistant
  • Bridgeport, CT
National Provider Identifier
1528539251
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4350 Issued in CT
Practice address
267 Grant St
Bridgeport, CT 06610-2870
Phone
(203) 384-3566
NPI assigned
Dec 6, 2018
Last updated
Dec 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4350 CT Primary

Addresses

Primary practice location

267 Grant St
Bridgeport, CT 06610-2870

Mailing address

132 Race Hill Rd
Guilford, CT 06437-1011
Phone (570) 768-8142

Other identifiers 2

IdentifierTypeStateIssuer
4350OtherCTCONNECTICUT PHYSICIAN ASSISTANT LICENSE
69937OtherCTCONNECTICUT CONTROLLED SUBSTANCE REGISTRATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817000355 NH Practitioner - Physician Assistant 6901143684 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Ocumed LLCGroup PAC ID 7719410018, 31 clinicians

Practice addresses (Care Compare)

65 Calef Hwy
Lee, NH 03861-6703
Phone (603) 868-8507

701 Central Ave
Dover, NH 03820-3403
Phone (603) 609-6700

789 Central Ave
Dover, NH 03820-2526
Phone (603) 742-5252

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Emergency Physicians, PC CurrentSince Jul 1, 2023 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients

Locations

701 Central Ave
Dover, NH 03820
Phone (603) 609-6700

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

Interoperability endpoints

  • Direct secure messaging: baish.erik.wdh@direct.partners.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1528539251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 RACE HILL RD",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371011",
            "telephone_number": "570-768-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 GRANT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102870",
            "telephone_number": "203-384-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAISH",
        "first_name": "ERIK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT PHYSICIAN ASSISTANT LICENSE",
            "identifier": "4350",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT CONTROLLED SUBSTANCE REGISTRATION",
            "identifier": "69937",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.