NPIMap

Individual provider Active NPI

Michael J Baldeck, D.O.

  • Family Medicine Physician
  • Lewiston, ID
National Provider Identifier
1669428967
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0-185 Issued in ID
Practice address
222 Southway Ave Ste 2a
Lewiston, ID 83501-2703
Phone
(208) 798-4818
Fax
(208) 798-8711
NPI assigned
May 26, 2006
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0-185 ID Primary

Addresses

Primary practice location

222 Southway Ave Ste 2a
Lewiston, ID 83501-2703

Mailing address

415 6TH Street
Attn: Physician Services
Lewiston, ID 83501-2434
Phone (208) 750-7462

Other practice location 1

222 Southway Ave Ste C
Lewiston, ID 83501-2703
Phone (208) 798-4818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250813001444 AL Practitioner - Family Practice 7719907625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 University Blvd E
Suite 810
Tuscaloosa, AL 35401-7479
Phone (205) 343-8070

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0-185IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The DCH Health Care Authority CurrentSince Aug 4, 2025 Accepting new patients
Druid City Physician Services, LLC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Druid City Physician Services, LLC Current Accepting new patients
West Alabama Palliative Care Service LLC Current Accepting new patients
Druid City Physician Services, LLC CurrentSince Jul 1, 2025 Accepting new patients
DCH Healthcare Authority Current Accepting new patients
The DCH Healthcare Authority CurrentSince Aug 4, 2025 Accepting new patients
St. Joseph Hospital LLC PastSince Aug 4, 2024 Accepting new patients
The DCH Health Care Authority Past Accepting new patients
Northport Medical Center Past Accepting new patients
The DCH Health Care Authority Past Accepting new patients

Locations

2700 Hospital Dr
Northport, AL 35476
Phone (205) 333-4500

3901 Greensboro Ave
Ste A
Tuscaloosa, AL 35405
Phone (205) 759-6165

701 University Blvd E
Ste 807
Tuscaloosa, AL 35401
Phone (205) 333-4528

701 University Blvd E
Ste 810
Tuscaloosa, AL 35401
Phone (205) 343-8070

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1669428967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 6TH STREET",
            "address_2": "ATTN: PHYSICIAN SERVICES",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012434",
            "telephone_number": "208-750-7462",
            "fax_number": "208-750-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SOUTHWAY AVE STE 2A",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012703",
            "telephone_number": "208-798-4818",
            "fax_number": "208-798-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Southway Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835012703",
            "country_code": "US",
            "telephone_number": "208-798-4818",
            "fax_number": "208-798-8711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDECK",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "0-185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.