Individual provider Active NPI

David John Bakker, PA-C

  • Medical Physician Assistant
  • Arlington Heights, IL
National Provider Identifier
1710998737
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10000523A Issued in IN
Practice address
800 W Central Rd
Arlington Heights, IL 60005-2349
Phone
(847) 618-3040
NPI assigned
Aug 11, 2006
Last updated
Mar 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10000523A IN Primary

Addresses

Primary practice location

800 W Central Rd
Arlington Heights, IL 60005-2349

Mailing address

2045 W Concord PL
Unit 501
Chicago, IL 60647-5628
Phone (773) 677-6613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20070626000300 IL Practitioner - Physician Assistant 2668571035 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000523AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bestpractices of Northwest SC Past Accepting new patients
Emergency Healthcare Physicians, LTD. Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1710998737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 W CONCORD PL",
            "address_2": "UNIT 501",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475628",
            "telephone_number": "773-677-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CENTRAL RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052349",
            "telephone_number": "847-618-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKKER",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10000523A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.