Active NPI
Deborah Gloria Baca-Dietz, NP
- Family Nurse Practitioner
- Salem, OR
National Provider Identifier
1780196220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 201708782NP-PP
- Practice address
- 1233 Edgewater St NW
Salem, OR 97304 - Phone
- (503) 378-7526
- NPI assigned
- Oct 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 201708782NP-PP | OR | Primary |
Addresses
Primary practice location
1233 Edgewater St NW
Salem, OR 97304
Mailing address
1233 Edgewater St NW
Salem, OR 97304-4049
Phone (503) 378-7526
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | debbie.bacadietz.p1@direct.nwhumanservices.nextgenshare.com | Direct | Northwest Human Services, Inc. |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201708782NP-PP | OR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P | Current | Accepting new patients | |
| Willamette Valley Hospice Inc | Past | Accepting new patients |
Locations
2600 Center St NE
Salem, OR 97301
Phone (503) 945-2800
Interoperability endpoints
- debbie.bacadietz.p1@direct.nwhumanservices.nextgenshare.com
Organizations & group practices 2
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.
-
dba Oregon State Hospital (Salem)
- Psychiatric Hospital
- Salem, OR
- NPI 1508802489
-
- Community Based Hospice Care Agency
- Salem, OR
- NPI 1093715070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1780196220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1233 EDGEWATER ST NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973044049",
"telephone_number": "503-378-7526",
"fax_number": "503-588-5815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 EDGEWATER ST NW",
"city": "SALEM",
"state": "OR",
"postal_code": "97304",
"telephone_number": "503-378-7526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACA-DIETZ",
"first_name": "DEBORAH",
"middle_name": "GLORIA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-24",
"last_updated": "2023-11-27",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "201708782NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "debbie.bacadietz.p1@direct.nwhumanservices.nextgenshare.com",
"affiliation": "Y",
"affiliationName": "Northwest Human Services, Inc.",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1233 Edgewater St NW",
"city": "Salem",
"state": "OR",
"country_code": "US",
"postal_code": "973044049",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.