Individual provider Active NPI

Jon M Baker, MD

  • Surgery Physician
  • Warsaw, NY
National Provider Identifier
1881676732
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
163390 Issued in NY
Practice address
400 N Main St
Warsaw, NY 14569-1025
Phone
(585) 786-8940
NPI assigned
Nov 16, 2005
Last updated
Jun 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 163390 NY Primary

Addresses

Primary practice location

400 N Main St
Warsaw, NY 14569-1025

Mailing address

PO Box 4860
Murrells Inlet, SC 29576-2698
Phone (843) 651-2624

Other identifiers 3

IdentifierTypeStateIssuer
02120836MedicaidNY
1711149OtherNYIH
000526291003OtherNYBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20071022000176 NY Practitioner - General SurgeryPractitioner - Hand Surgery 2163518267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Hand Surgery
Education
Saint Louis University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis CountyGroup PAC ID 2668463779, 39 clinicians

Practice addresses (Care Compare)

7785 N State St
Suite 130
Lowville, NY 13367-1229
Phone (315) 376-5163

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy85
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux26
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County CurrentSince May 20, 2017 Accepting new patients
Lewis County General Hospital Surgery CurrentSince May 20, 2017 Accepting new patients
Lewis County Past Accepting new patients

Locations

7785 N State St
Lowville, NY 13367
Phone (315) 376-5102

7785 N State St
#130
Lowville, NY 13367
Phone (315) 376-5163

7785 N State St
#13282
Lowville, NY 13367
Phone (315) 376-5200

7785 N State St
Ste 130
Lowville, NY 13367
Phone (315) 376-5163

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1881676732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4860",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295762698",
            "telephone_number": "843-651-2624",
            "fax_number": "843-491-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691025",
            "telephone_number": "585-786-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "JON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "163390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02120836",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IH",
            "identifier": "1711149",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000526291003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

Verify at the official NPI Registry.