Individual provider Active NPI

Julissa Baez, MD

  • Pediatric Hospice and Palliative Medicine Physician
  • New York, NY
National Provider Identifier
1609091909
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X
License
232901 Issued in NY
Practice address
232 E 12TH St
Unit 1G
New York, NY 10003-9151
Phone
(646) 524-6351
Fax
(646) 524-6362
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 232901 NY Primary

Addresses

Primary practice location

232 E 12TH St
Unit 1G
New York, NY 10003-9151

Mailing address

2306 Esplanade Ave
Bronx, NY 10469-5408
Phone (347) 275-2030

Other identifiers 1

IdentifierTypeStateIssuer
02797648MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
232901NYMDPediatric Hospice and Palliative Medicine Physician

Interoperability endpoints

  • Direct secure messaging: jbaez43967@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1609091909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 ESPLANADE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695408",
            "telephone_number": "347-275-2030",
            "fax_number": "347-275-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 E 12TH ST",
            "address_2": "UNIT 1G",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039151",
            "telephone_number": "646-524-6351",
            "fax_number": "646-524-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "JULISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "NY",
            "license": "232901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02797648",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.