Individual provider Active NPI

Lydia Bakaki

  • Family Nurse Practitioner
  • Berea, OH
National Provider Identifier
1952051922
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0031060 Issued in OH
Practice address
133 Stonefield Dr
Berea, OH 44017-3129
Phone
(440) 625-0955
NPI assigned
Mar 24, 2022
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0031060 OH Primary
Family Health Clinical Nurse Specialist 364SF0001X 0031060 OH

Addresses

Primary practice location

133 Stonefield Dr
Berea, OH 44017-3129

Mailing address

100 Washington Ave S Ste 1210
Minneapolis, MN 55401-2104
Phone (866) 492-5336

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220531000955 OH Practitioner - Nurse Practitioner 3375921562 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0031060OHMDFamily Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Bakaki and Associates Inc CurrentSince Mar 27, 2022 Accepting new patients
Complexcare Medical Group Midwest H PLLC CurrentSince May 4, 2025 Accepting new patients
Complexcare Medical Group Midwest M PLLC CurrentSince Jun 9, 2025 Accepting new patients
Theoria Medical CurrentSince Jul 11, 2024 Accepting new patients
Signify Health, LLC CurrentSince May 1, 2022 Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

175 S 3rd St
Ste 200
Columbus, OH 43215
Phone (267) 817-8902

1865 Countryside Dr
Fremont, OH 43420
Phone (248) 660-1200

717 S 30th St
Newark, OH 43056
Phone (740) 522-1171

7120 Port Sylvania Dr
Toledo, OH 43617
Phone (419) 841-2200

1030 High St
Worthington, OH 43085
Phone (614) 876-7356

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1952051922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WASHINGTON AVE S STE 1210",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554012104",
            "telephone_number": "866-492-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 STONEFIELD DR",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440173129",
            "telephone_number": "440-625-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKAKI",
        "first_name": "LYDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0031060",
            "primary": true
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "OH",
            "license": "0031060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.