Individual provider Active NPI

Benjamin Bryce Baker

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1669178729
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4240 Issued in MN
Practice address
1619 Dayton Ave Ste 309
Saint Paul, MN 55104-6276
Phone
(515) 480-8396
NPI assigned
Jan 31, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4240 MN Primary

Addresses

Primary practice location

1619 Dayton Ave Ste 309
Saint Paul, MN 55104-6276

Mailing address

424 Rehnberg PL
West Saint Paul, MN 55118-3213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260410002709 MN Practitioner - Marriage and Family Therapist 7113492786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3204 E 43Rd St
Minneapolis, MN 55406-3858

PO Box
Suite 186859
Hamden, CT 06518-7014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4240MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Center for Integration LLC Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1669178729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 REHNBERG PL",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551183213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 DAYTON AVE STE 309",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046276",
            "telephone_number": "515-480-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "BENJAMIN",
        "middle_name": "BRYCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.