Brandon Baker, MD
Individual provider Active NPI Pediatrics Physician · Oklahoma City, OK
NPI 1720659592 · NPPES record last updated Jul 2, 2025
Key facts
- NPI
- 1720659592
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 39630 (OK)
- Practice address
- 500 SW 44TH St
Oklahoma City, OK 73109-3540 - Phone
- (405) 632-6688
- NPI assigned
- Jul 2, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250721003165 | OK | Practitioner - Pediatric Medicine | 5799291373 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39630 | OK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Variety Care, Inc. | Current |
Accepting new patients | |
| Variety Care, Inc. | Current | Accepting new patients | |
| Variety Care, Inc. | Current |
Accepting new patients |
Locations
500 SW 44th St
Oklahoma City, OK 73109
Phone (405) 235-6466
3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209
Interoperability endpoints
- bbaker815305@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 39630 | OK | Yes |
Addresses
Primary practice location
500 SW 44TH St
Oklahoma City, OK 73109-3540
Mailing address
3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688
Other practice location 1
1200 Childrens Ave # 14000
Oklahoma City, OK 73104-4637
Phone (405) 271-6615
Other providers in Oklahoma City, OK
- Jacob Bakare
- Ruth Bakare
- Mariah Renae Baker-Driskell
- Michelle Christine Baker-Rhodes
- Ashley Baker
- Brian Baker
- Cody Baker
- Elizabeth I Baker
- Gregory D Baker
- Hallie Elizabeth Baker
All providers in Oklahoma City, OK · Pediatrics Physician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.