| Wallace C Baker, MD | |
|
1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | |
| (208) 524-6633 | |
| (208) 524-9952 |
| Full Name | Wallace C Baker |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 33 Years |
| Location | 1880 John Adams Pkwy, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083696967 | NPI | - | NPPES |
| 000010001770 | Other | ID | BLUE SHIELD PROVIDER NUMB |
| 000010027582 | Other | ID | BLUE SHIELD GROUP |
| 080097138 | Other | ID | RR MEDICARE |
| 8K123 | Other | ID | BLUE CROSS GROUP |
| 002796800 | Medicaid | ID | |
| 266877 | Other | ID | DMBA |
| 1134140148 | Other | ID | BAKER FAMILY GROUP NPI |
| 72132 | Other | ID | IDAHO BLUE CROSS PROVIDER |
| 807937700 | Medicaid | ID | |
| DE1614 | Other | ID | RR MEDICARE GRP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M2619 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Eden Home Health | Ammon, ID | Home health agency |
| Advanced Home Health | Idaho falls, ID | Home health agency |
| Encompass Health Home Health Of Eastern Idaho | Idaho falls, ID | Home health agency |
| Heritage Hospice | Pocatello, ID | Hospice |
| Mountain View Hospital | Idaho falls, ID | Hospital |
| Eastern Idaho Regional Medical Center | Idaho falls, ID | Hospital |
| Life Care Center Of Idaho Falls | Idaho falls, ID | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wallace C Baker | 0446208904 | 6 |
| Entity Name | Wallace C Baker |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134140148 PECOS PAC ID: 0446208904 Enrollment ID: O20050111000707 |
| Mailing Address | Practice Location Address |
|---|---|
| Wallace C Baker, MD 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 Ph: (208) 524-6633 | Wallace C Baker, MD 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 Ph: (208) 524-6633 |
Dr. Matthew Scott Payne, D.O Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3200 Channing Way Ste 304, Idaho Falls, ID 83404 Phone: 208-535-4580 Fax: 208-535-4520 | |
Matthew G Taylor, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3200 Channing Way Ste 205, Idaho Falls, ID 83404 Phone: 208-535-4580 Fax: 208-535-4520 | |
Mr. Bradly Kenneth Leroy Brown, PA-C Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2730 Channing Way, Idaho Falls, ID 83404 Phone: 208-542-7100 Fax: 208-542-7150 | |
Michael Thomas Long, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-973-2144 | |
Dr. Peter Jeffrey Thompson, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1995 E 17th St, Idaho Falls, ID 83404 Phone: 208-529-5252 Fax: 208-529-4434 | |
Dr. Eric Bennett, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2775 Channing Way, Idaho Falls, ID 83404 Phone: 208-524-0133 |