Marissa Baca, PLLC

Primary specialty

Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X

Legal business name

MARISSA BACA, PLLC

Practice address

32000 Telegraph Rd
Bingham Farms, MI 48025-2442

Phone

(248) 647-5800

Fax

(248) 647-1799

NPI assigned

Oct 10, 2019

Organization subpart

No

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

Authorized official

Name

Marissa Baca, MD

Title

Owner

Phone

(586) 322-2650

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1740822741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N CRANBROOK CROSS RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483012765",
            "telephone_number": "586-322-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32000 TELEGRAPH RD",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252442",
            "telephone_number": "248-647-5800",
            "fax_number": "248-647-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISSA BACA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "BACA",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-322-2650",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbaca@straithclinic.com",
            "affiliation": "N",
            "endpointDescription": "Physician email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "32000 Telegraph Rd",
            "city": "Bingham Farms",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480252442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.