Active NPI
Elsi Maria Baccari, D.O.
- Family Medicine Physician
- Orchard Lake, MI
National Provider Identifier
1699827303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 18403
- Practice address
- 2861 Orchard Place
Orchard Lake, MI 48324 - Phone
- (313) 378-9914
- Fax
- (906) 387-2825
- NPI assigned
- Jan 16, 2007
- Last updated
- Jul 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101009526 | MI | |
| Family Medicine Physician | 207Q00000X | 18403 | WI | Primary |
Addresses
Primary practice location
2861 Orchard Place
Orchard Lake, MI 48324
Mailing address
2861 Orchard Place
Orchard Lake, MI 48324
Phone (313) 378-9914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5170118 | Other | MI | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18403 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baccari PC | Past | Accepting new patients | |
| Northern Michigan Emergenc Physicians, LLP | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sault Walk In Clinic
- General Practice Physician
- Sault Sainte Marie, MI
- NPI 1255548814
-
- Emergency Medicine Physician
- Sault Sainte Marie, MI
- NPI 1922105113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1699827303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2861 ORCHARD PLACE",
"city": "ORCHARD LAKE",
"state": "MI",
"postal_code": "48324",
"telephone_number": "313-378-9914",
"fax_number": "906-387-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2861 ORCHARD PLACE",
"city": "ORCHARD LAKE",
"state": "MI",
"postal_code": "48324",
"telephone_number": "313-378-9914",
"fax_number": "906-387-2825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACCARI",
"first_name": "ELSI",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101009526",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "18403",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5170118",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orchard Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.