Individual provider Active NPI

Alicia Ellen Baldwin

  • Physical Therapist
  • Seymour, IN
National Provider Identifier
1750938296
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05013410A Issued in IN
Practice address
200 S Obrien St
Seymour, IN 47274-2440
Phone
(812) 522-9574
Fax
(812) 522-2576
NPI assigned
Aug 20, 2019
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05013410A IN Primary

Addresses

Primary practice location

200 S Obrien St
Seymour, IN 47274-2440

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Other names 1

  • Alicia Ellen Pollert Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbaldwin32689@bhkydirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191008000217 IN Practitioner - Physical Therapist in Private Practice 1052642956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1373 E State Rd
Madison, IN 47250-7328
Phone (812) 801-0810

7600 Hwy 60
Sellersburg, IN 47172-2040

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05013410AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
KNP Physcial Therapy Inc Physical Therapist CurrentSince Jun 9, 2020 Accepting new patients
Baptist Health Medical Group Inc Physical Therapist CurrentSince Nov 18, 2019 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Nov 18, 2019 Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

1111 N State St
North Vernon, IN 47265
Phone (812) 346-5400

7600 Highway 60
Ste 300
Sellersburg, IN 47172
Phone (812) 542-4684

Interoperability endpoints

  • Direct secure messaging: abaldwin107693@bhkydirect.com

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": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1750938296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S OBRIEN ST",
            "city": "SEYMOUR",
            "state": "IN",
            "postal_code": "472742440",
            "telephone_number": "812-522-9574",
            "fax_number": "812-522-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "ALICIA",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013410A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbaldwin32689@bhkydirect.com",
            "affiliation": "N",
            "address_1": "7600 Highway 60 Ste 300",
            "city": "Sellersburg",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471722040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "POLLERT",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seymour, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.