Fidelina Nitura Baraceros, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

FB035468 Issued in MI

Practice address

43750 Woodward Ave
Ste 104
Bloomfield Hills, MI 48302-5063

Phone

(248) 334-6000

Fax

(248) 334-8740

NPI assigned

Jun 15, 2006

Last updated

Mar 21, 2017By the provider in NPPES

Sex

Female

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bloomfield Hills Pediatrics

  • Specialist
  • Bloomfield Hills, MI
  • NPI 1346361946
  NPD (past) Authorized official
• SJMH Medical Practice-SMHC

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1346284684

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1841234622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43750 WOODWARD AVE",
            "address_2": "STE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025063",
            "telephone_number": "248-334-6000",
            "fax_number": "248-334-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43750 WOODWARD AVE",
            "address_2": "STE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025063",
            "telephone_number": "248-334-6000",
            "fax_number": "248-334-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARACEROS",
        "first_name": "FIDELINA",
        "middle_name": "NITURA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "FB035468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC NUMBER",
            "identifier": "FB035468",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN ID #",
            "identifier": "101152",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV ID #",
            "identifier": "3506341231",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195380310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Bailey
• Tancier V. Baker, LPC
• Baldwin Urgent Care PLLC
• David George Banda, D.D.S.
• Suresha Chandani Bandara, M.D.
• Barbara Ruskin LLC
• Michelle Barile, DPT
• Barry P. August O.D.,P.C.
• Bart Anthony PC (The Counseling Centre)
• Bart Anthony PC (The Counseling Centre)

• Pediatrics Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.