Individual provider Active NPI

Phyllis Baer, MD

  • Internal Medicine Physician
  • Dorchester, MA
National Provider Identifier
1548234065
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37726 Issued in MA
Practice address
398 Neponset Ave
Dorchester, MA 02122-3134
Phone
(617) 282-3200
Fax
(617) 282-7928
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37726 MA Primary

Addresses

Primary practice location

398 Neponset Ave
Dorchester, MA 02122-3134

Mailing address

1135 Morton Street
Mattapan, MA 02126-2834
Phone (617) 533-2300

Other identifiers 1

IdentifierTypeStateIssuer
2067196MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20120308000078 MA Practitioner - Internal Medicine 7517126758 Practice locations: Quincy, MA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37726MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1548234065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 MORTON STREET",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262834",
            "telephone_number": "617-533-2300",
            "fax_number": "617-282-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 NEPONSET AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223134",
            "telephone_number": "617-282-3200",
            "fax_number": "617-282-7928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAER",
        "first_name": "PHYLLIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "37726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2067196",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.