Jerome Wayne Baca, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2012-0025 Issued in NM

Practice address

6701 Jefferson St NE
Albuquerque, NM 87109

Phone

(505) 727-6200

Fax

(505) 727-9590

NPI assigned

Aug 1, 2012

Last updated

Nov 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lovelace Women's Hospital Hospital, Albuquerque, NM, CCN 320017
• Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074
• Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbaca6696@ahs.direct-ci.com

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.

• Southwest Medical Associates, LLC

  dba Lovelace Medical Group

  • General Practice Physician
  • Albuquerque, NM
  • NPI 1164491072
  Medicare reassignment Care Compare group NPD
• MD for Men, LLC

  • Urology Physician
  • Albuquerque, NM
  • NPI 1750704102
  Medicare reassignment
• Southwest Medical Associates, LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1578255253
  NPD
• Dermatology of New Mexico LLC

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1104468438
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lovelace Health System LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1306914213
  Care Compare affiliation
• Lovelace Health System, LLC

  dba Lovelace Westside Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1649373887
  Care Compare affiliation
• Lovelace Health System, LLC

  dba Lovelace Women's Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1982799375
  Care Compare affiliation

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1811243462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094318",
            "telephone_number": "505-727-6200",
            "fax_number": "505-727-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-727-6200",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 Broadway Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022372",
            "country_code": "US",
            "telephone_number": "505-242-3991 x266",
            "fax_number": "505-243-8405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 Broadway Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022372",
            "country_code": "US",
            "telephone_number": "505-242-3991 x266",
            "fax_number": "505-243-8405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACA",
        "first_name": "JEROME",
        "middle_name": "WAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2012-0025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM MEDICAL LICENSE",
            "identifier": "PA2012-0025",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64471870",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Baca
• Jaime D Baca
• Janet Gale Baca, CRNFA RN BSN CNOR
• Jeannette Verna Baca, ED.D., LPCC
• Jennifer Baca
• Jessica Victoria Baca
• Joclyn Baca
• Joey Baca
• John Alfredo Baca
• Jordan Chaz Baca

• Medical Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.
• 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.