NPIMap

Individual provider Active NPI

Gerald Baldwin, PA-C

  • Medical Physician Assistant
  • Chino Valley, AZ
National Provider Identifier
1902206071
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7033 Issued in AZ
Practice address
474 N Hwy 89
Chino Valley, AZ 86323-5993
Phone
(928) 636-5680
Fax
(928) 636-5853
NPI assigned
Aug 26, 2014
Last updated
Feb 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 7033 AZ Primary
Physician Assistant 363A00000X PA60507644 WA

Addresses

Primary practice location

474 N Hwy 89
Chino Valley, AZ 86323-5993

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (602) 406-4786

Other practice location 1

1001 Division St
Prescott, AZ 86301-1601
Phone (928) 445-5648

Other identifiers 1

IdentifierTypeStateIssuer
376503MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180607001574 AZ Practitioner - Physician Assistant 7719108182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 Gail Gardner Way
Suite 100
Prescott, AZ 86305-1631
Phone (928) 777-0700

3120 Clearwater Dr
Prescott, AZ 86305-7131
Phone (928) 771-3704

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60507644WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yavapai Regional Medical Center Physician Care LLC CurrentSince Jul 16, 2018 Accepting new patients
Prescott Gastroenterology Past Accepting new patients

Locations

474 N US Highway 89
Chino Valley, AZ 86323
Phone (520) 636-4355

1001 Division St
Prescott, AZ 86301
Phone (928) 445-4818

3120 Clearwater Dr
Prescott, AZ 86305
Phone (928) 445-4818

7700 E Florentine Rd
Bldg B
Prescott Valley, AZ 86314
Phone (928) 442-8710

7700 E Florentine Rd
Prescott Vly, AZ 86314
Phone (928) 445-2700

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 5

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": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1902206071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 N HWY 89",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "863235993",
            "telephone_number": "928-636-5680",
            "fax_number": "928-636-5853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Division St",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863011601",
            "country_code": "US",
            "telephone_number": "928-445-5648",
            "fax_number": "928-445-5079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "GERALD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "7033",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60507644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376503",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Valley, AZ

Sources for this page

Verify at the official NPI Registry.