SAMANTHA BACA (NPI# 1659504728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659504728 |
| Entity Type | Individual |
| Full Name | SAMANTHA BACA |
| Credential | P.A.-C. |
| Practice Address |
1821 Carlisle Blvd Ne Albuquerque NM 87110-4905 |
| Mailing Address |
Po Box 6310 Las Cruces NM 88006-6310 |
| Practice Telephone | 5052551228 |
| Practice Fax Number | 5052551394 |
| Mailing Telephone | 5755565960 |
| Mailing Fax Number | 5755565959 |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2018-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA2014-0073 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 77330811 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264958 | Samantha Baca | Psychologist | 160 W 86th St, New York, NY 10024-4018 | 2020-08-08 |
| Street Address |
1821 CARLISLE BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-4905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841309176 | Donald J Ortiz | Family Medicine | 1821 Carlisle Blvd Ne, Midtown Family Medicine, Albuquerque, NM 87110-4905 | 2006-08-30 |
| 1952601841 | Angela Lovell | Physician Assistant | 1821 Carlisle Blvd Ne, Albuquerque, NM 87110-4905 | 2010-10-26 |
| 1396906798 | Unmsom 89 | Family Medicine | 1821 Carlisle Blvd Ne, Albuquerque, NM 87110-4905 | 2008-06-19 |
| 1215046545 | Michael A Montoya | Family Medicine | 1821 Carlisle Blvd Ne, Albuquerque, NM 87110-4905 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474550 | Mara Swartzentruber | Physician Assistant | 3310 Linda Vista Ave Se, Albuquerque, NM 87106-1514 | 2020-10-13 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1487287413 | Thomas Clise | Physician Assistant | 629 San Pablo St Ne, Albuquerque, NM 87108-2137 | 2020-02-18 |
| 1912547324 | Kathleen Joyce L'heureux | Physician Assistant | 8124 Ventana Cielo Ave Nw, Albuquerque, NM 87114-5988 | 2020-01-14 |
| 1265097869 | Amber Zoubovitch | Physician Assistant | 7200 Montgomery Blvd Ne Ste 7121, Albuquerque, NM 87109-1510 | 2019-05-08 |
| 1639680739 | Wesley A Parker | Physician Assistant | 3777 Mdg, 2050a Second Street Se, Albuquerque, NM 87117-5522 | 2017-10-16 |
| 1003327487 | Elise Nicole Pedigo | Physician Assistant | 4700 Jefferson St Ne Ste 700, Albuquerque, NM 87109-2132 | 2017-10-12 |
| 1194170605 | Anna Marie Siow | Physician Assistant | 1014 Hummingbird Pl Sw, Albuquerque, NM 87105-8130 | 2016-05-03 |
| 1285032367 | Travis Householder | Physician Assistant | 201 Cedar St Se Ste 4610, Presbyterian Heart Group, Albuquerque, NM 87106-4936 | 2014-12-05 |
| 1508276973 | Stephanie Gonzales | Physician Assistant | 12241 Academy Rd Ne Ste 204, Albuquerque, NM 87111 | 2014-05-06 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on SAMANTHA BACA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.