Pablo Andres Baeza Breinbauer

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

100154 Issued in CA

Practice address

1501 Fruitvale Ave Apt 2
Oakland, CA 94601-2322

Phone

(510) 535-6200

Fax

(510) 535-4167

NPI assigned

May 11, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Concord, CA
  • NPI 1538181482
  Medicare reassignment

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

{
    "created_epoch": "1557532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1811553274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 FRUITVALE AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012322",
            "telephone_number": "510-535-6200",
            "fax_number": "510-535-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 FRUITVALE AVE APT 2",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012322",
            "telephone_number": "510-535-6200",
            "fax_number": "510-535-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZA BREINBAUER",
        "first_name": "PABLO",
        "middle_name": "ANDRES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-11",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "100154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART B MEDICARE",
            "identifier": "ZZZ29799Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC80040F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART A MEDICARE",
            "identifier": "05-1063",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy E. Bae, MD
• Minah Baek, RN
• David M. Baer, MD
• Paula Baessler
• Stephanie Lizette Baez-Aguilar
• Christine Bagaoisan, PT
• Virgil Gaba Bagaoisan
• Naomi Bagby, LCSW
• Rahman Bagby
• Ramatoulie I Bah

• Clinical Social Worker in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.