Active NPI
Elizabeth Jean Baez, PNP
- Pediatric Nurse Practitioner
- Vista, CA
National Provider Identifier
1659519940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- NP 21654
- Practice address
- 1000 Vale Terrace Dr
Vista, CA 92084-5218 - Phone
- (760) 631-5000
- NPI assigned
- Jan 26, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 101.00072446 | VT | |
| Pediatric Nurse Practitioner | 363LP0200X | 4125 | CT | |
| Pediatric Nurse Practitioner | 363LP0200X | 275033 | MA | |
| Pediatric Nurse Practitioner | 363LP0200X | 382131 | NY | |
| Pediatric Nurse Practitioner | 363LP0200X | AP 3252 | AZ | |
| Pediatric Nurse Practitioner | 363LP0200X | NP 21654 | CA | Primary |
Addresses
Primary practice location
1000 Vale Terrace Dr
Vista, CA 92084-5218
Mailing address
465 La Tortuga Dr
Suite 210
Vista, CA 92081-4320
Phone (760) 631-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260612002150 | CA | Order and Referring Only - Nurse Practitioner | 7416012802 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004125 | CT | MD | Dental Hygienist |
| AP 3252 | AZ | MD | Pediatric Nurse Practitioner |
| NP 21654 | CA | MD | Pediatric Nurse Practitioner |
| 275033 | MA | MD | Pediatric Nurse Practitioner |
| 382131 | NY | MD | Pediatric Nurse Practitioner |
| 101.00072446 | VT | MD | Pediatric Nurse Practitioner |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children'S Hospital San Diego | Past | Accepting new patients | |
| Vista Community Clinic | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- elizabeth.baeznp.p1@direct.vistacommunityclinic.nextgenshare.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
-
- Federally Qualified Health Center (FQHC)
- Oceanside, CA
- NPI 1649363375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351814400000",
"number": "1659519940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 LA TORTUGA DR",
"address_2": "SUITE 210",
"city": "VISTA",
"state": "CA",
"postal_code": "920814320",
"telephone_number": "760-631-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 VALE TERRACE DR",
"city": "VISTA",
"state": "CA",
"postal_code": "920845218",
"telephone_number": "760-631-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEZ",
"first_name": "ELIZABETH",
"middle_name": "JEAN",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-26",
"last_updated": "2012-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "VT",
"license": "101.00072446",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CT",
"license": "4125",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MA",
"license": "275033",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "382131",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AZ",
"license": "AP 3252",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "NP 21654",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.