Jung Baccam, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

290121 Issued in AZ

Practice address

12361 W Bola Dr Ste 109
Surprise, AZ 85378-9021

Phone

(623) 227-1000

Fax

(623) 227-2000

NPI assigned

Mar 6, 2023

Last updated

Mar 20, 2025By 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

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prescott Healthcare Solutions LLCGroup PAC ID 4385940295, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jung.baccam@49412312072196.direct.elationemr.com

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.

• Prescott Healthcare Solutions LLC

  dba Optima Medical

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1821454505
  Medicare reassignment Care Compare group NPD
• Sean M Ormond MD LLC

  • Pain Medicine (Anesthesiology) Physician
  • Glendale, AZ
  • NPI 1689282998
  Medicare reassignment NPD
• Atlas Outpatient

  • Ambulatory Surgical Clinic/Center
  • Glendale, AZ
  • NPI 1639982960
  NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1891495131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12361 W BOLA DR STE 109",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789021",
            "telephone_number": "623-227-1000",
            "fax_number": "623-227-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12361 W BOLA DR STE 109",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789021",
            "telephone_number": "623-227-1000",
            "fax_number": "623-227-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7725 N 43rd Ave Ste 510",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850515771",
            "country_code": "US",
            "telephone_number": "623-207-5465",
            "fax_number": "623-207-5405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16928 W Bell Rd Ste 701",
            "address_purpose": "LOCATION",
            "city": "Surprise",
            "state": "AZ",
            "postal_code": "853748948",
            "country_code": "US",
            "telephone_number": "623-850-0026",
            "fax_number": "623-850-0027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACCAM",
        "first_name": "JUNG",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "290121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Azona Wellness (Sonoran Pain Solutions)
• Alessi Azores
• Aztherapytok, LLC
• Tinuola K Babarinde, MD
• Patricia Baca, RDH
• Lauren Nicole Bachman, DNP, AGNP-BC
• Bernadette Badley
• Mark Badria
• Omar Baghdadi, MD
• Bailey Chiropractic

• Family Nurse Practitioner in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.