Dianna L Baca, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

56811 Issued in NM

Practice address

400 Tijeras Ave NW Ste 200
Albuquerque, NM 87102-3252

Phone

(888) 562-5442

NPI assigned

Jul 12, 2019

Last updated

Jul 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, UT, WA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dbaca9903@direct-prd.molinahealthcare.com
• FHIR API: https://epicproxy.et1057.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Molina Care Connections, LLC.

  dba Molina CC

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  NM

  Medicare reassignment NPD
• Molina Healthcare of Utah Inc

  • Family Nurse Practitioner
  • Midvale, UT
  • NPI 1619486396
  Medicare reassignment NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Everett, WA
  • NPI 1912235060
  Medicare reassignment NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163
  NPD

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1740832401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TIJERAS AVE NW STE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023252",
            "telephone_number": "505-681-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TIJERAS AVE NW STE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023252",
            "telephone_number": "888-562-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "DIANNA",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "56811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Baca, RDH
• Crystal S Baca, AU.D.
• David Baca
• Derrick Ray Baca, DDS
• Diana Marie Baca, DDS
• Dianna Ruth Baca
• Elizabeth Ann Baca, SPEECH-LANGUAGE PATH
• Elizabeth F Baca
• Erika Baca
• Erlinda Baca

• Family Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.