Emily Randolph Bacon

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A142488 Issued in CA

Practice address

2500 Metrohealth Dr
Cleveland, OH 44109-1900

Phone

(216) 778-4486

NPI assigned

Apr 9, 2013

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eden Emergency Medical Group IncGroup PAC ID 7012802333, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

Merit-based Incentive Payment System (MIPS)

Final score

96.02 of 100Reported as group

Quality

86.75

Improvement activities

40

Cost

77.68

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eden Emergency Medical Group Inc

  • Emergency Medicine Physician
  • Castro Valley, CA
  • NPI 1891786240
  Medicare reassignment Care Compare group NPD

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

• Sutter Bay Hospitals

  dba Eden Medical Center

  • General Acute Care Hospital
  • Castro Valley, CA
  • NPI 1063812907
  Care Compare affiliation

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1861835951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "EMILY",
        "middle_name": "RANDOLPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A142488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Back to Basics Treatment LLC
• Back to Basics Youth and Family Foundation
• Theresa Ann Backman, APRN, BC
• Bradley Brennan Backoff, D.P.M
• Elizabeth A Bacon, LISW
• Tanisha Brianna Bacon
• Emilene A Badalamenti, LSW
• Abigail Badar
• Charles Baddour
• Alex Michael Bade

• Emergency Medicine Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.