Marylou Baca

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

85944 Issued in NM

Practice address

707 Paseo de Peralta
Santa Fe, NM 87501-1922

Phone

(505) 989-8707

Fax

(505) 989-3536

NPI assigned

Nov 12, 2025

Last updated

Nov 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Taos Comprehensive Health Corporation

  dba UltiMED

  • Urgent Care Clinic/Center
  • Santa Fe, NM
  • NPI 1962568253

  Single Specialty

  Medicare reassignment NPD
• Angel Fire Primary Care

  • General Practice Physician
  • Angel Fire, NM
  • NPI 1922376896

  Single Specialty

  NPD (past)

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

• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1629938873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 PASEO DE PERALTA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011922",
            "telephone_number": "505-577-4543",
            "fax_number": "505-989-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PASEO DE PERALTA",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875011922",
            "telephone_number": "505-989-8707",
            "fax_number": "505-989-3536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7555 Enchanted Hills Blvd NE Ste 104",
            "address_purpose": "LOCATION",
            "city": "Rio Rancho",
            "state": "NM",
            "postal_code": "871448625",
            "country_code": "US",
            "telephone_number": "505-771-9833",
            "fax_number": "505-771-9834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACA",
        "first_name": "MARYLOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "85944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Baca, LADAC
• Jeannette Madelene Baca, LISW
• Jessica Baca, BMS
• Joshua Baca, MA, MPA, LMHC
• Lynn Baca
• Nancy Baca
• Robert O Bachicha, PT
• Back in Action Chiropractic, P.C.
• Back to Health Wellness Center. Inc
• Back to Self LLC

• Nurse Practitioner in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.