Krystal Marie Baciak, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.143060 Issued in IL

Practice address

5841 S Maryland Ave # Mc5068
Chicago, IL 60637-1443

Phone

(914) 419-6557

NPI assigned

Jun 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

New York Medical College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seattle Emergency Physicians Services Inc PSGroup PAC ID 4284521691, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025
• Swedish Medical Center Hospital, Seattle, WA, CCN 500027

Merit-based Incentive Payment System (MIPS)

Final score

90.95 of 100Reported as group

Quality

84.94

Improvement activities

40

Cost

78.1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seattle Emergency Physicians Services Inc PS

  • Emergency Medicine Physician
  • Seattle, WA
  • NPI 1376642298
  Medicare reassignment Care Compare group NPD

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

• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1306992151
  Care Compare affiliation
• Swedish Health Services

  dba Swedish Medical Center, Cherry Hill

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1356496582
  Care Compare affiliation

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1871857565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR STE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC5068",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "914-419-6557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1812 Verdugo Blvd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912081407",
            "country_code": "US",
            "telephone_number": "818-790-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACIAK",
        "first_name": "KRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "2828461",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A141508",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.143060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Bachman, LCSW
• Stephanie Bachmann
• Kelly E. R. Bachta, MD, PHD
• Trestin Bachtiger
• Piotr Jerzy Bachul, MD
• Busra Nur Bacik Goksu, MD
• Back Center of Chicago
• Back Home Chiropractic, S.C.
• Back to Health Chiropractic LTD
• Back to Life, P.C. of Il

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.