NPIMap

Individual provider Active NPI

Nicole A Baker, FNP

  • Family Nurse Practitioner
  • Champlain, NY
National Provider Identifier
1730661000
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343557 Issued in NY
Practice address
828 State Route 11
Champlain, NY 12919-4966
Phone
(518) 298-2691
Fax
(518) 298-8241
NPI assigned
Sep 4, 2018
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 343557 NY Primary

Addresses

Primary practice location

828 State Route 11
Champlain, NY 12919-4966

Mailing address

9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300

Other identifiers 1

IdentifierTypeStateIssuer
05626206MedicaidNY

Other names 1

  • Nicole A Trudeau Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicole.baker.1@1823.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190507000612 NY Practitioner - Nurse Practitioner 5890037139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

828 State Route 11
Champlain, NY 12919-4966
Phone (518) 298-2691

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
343557NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Current Accepting new patients
Hudson Headwaters Health Network CurrentSince May 13, 2019 Accepting new patients
Alice Hyde Medical Center CurrentSince Jun 1, 2023 Accepting new patients
Hudson Headwaters Health Network CurrentSince May 13, 2019 Accepting new patients
Hudson Headwaters Health Network Past Accepting new patients

Locations

828 State Route 11
Champlain, NY 12919
Phone (518) 298-2691

183 Park St
Ste 7
Malone, NY 12953
Phone (201) 616-2099

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

9 Carey Rd
Queensbury, NY 12804

Interoperability endpoints

  • Direct secure messaging: nicole.baker.1@1823.direct.athenahealth.com

Organizations & group practices 5

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 8

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1730661000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 STATE ROUTE 11",
            "city": "CHAMPLAIN",
            "state": "NY",
            "postal_code": "129194966",
            "telephone_number": "518-298-2691",
            "fax_number": "518-298-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "NICOLE",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05626206",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.baker.1@1823.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "828 State Route 11",
            "city": "Champlain",
            "state": "NY",
            "country_code": "US",
            "postal_code": "129194966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "TRUDEAU",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Champlain, NY

Sources for this page

Verify at the official NPI Registry.