Individual provider Active NPI

Toni Anne Baca, FNP

  • Family Nurse Practitioner
  • Medford, OR
National Provider Identifier
1780162032
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201806197NP-PP Issued in OR
Practice address
70 Bower Dr
Medford, OR 97501-3689
Phone
(541) 734-3430
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.017695 IL
Family Nurse Practitioner 363LF0000X 201806197NP-PP OR Primary

Addresses

Primary practice location

70 Bower Dr
Medford, OR 97501-3689

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (541) 734-3430

Other practice location 1

520 Medical Center Dr Ste 201
Medford, OR 97504-4334
Phone (541) 789-5705

Other identifiers 1

IdentifierTypeStateIssuer
500759907MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190425000274 OR Practitioner - Nurse Practitioner 5092057919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services Oregon 166 clinicians

Practice addresses (Care Compare)

940 Royal Ave
Medford, OR 97504-6194

Hospital & facility affiliations

  • Accentcare Home Health of Rogue Valley, LLC Home health agency, Medford, OR, CCN 387098
  • Providence Medford Home Care Home health agency, Medford, OR, CCN 387016
  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.017695ILMDFamily Nurse Practitioner
201806197NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2022 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

3225 Hillcrest Park Dr
Medford, OR 97504
Phone (541) 774-5700

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

70 Bower Dr
Medford, OR 97501
Phone (541) 732-8360

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1780162032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "541-734-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BOWER DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013689",
            "telephone_number": "541-734-3430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Medical Center Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975044334",
            "country_code": "US",
            "telephone_number": "541-789-5705",
            "fax_number": "541-789-5711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACA",
        "first_name": "TONI",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017695",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201806197NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500759907",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.