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DR. NICOLE M BACA MD
NPI 1093077802
Pediatrics - Pediatric Hematology-Oncology in West Hollywood, CA

Active since June 08, 2012PECOS Enrolled
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048(310) 423-4471(310) 423-0145 Get Directions Write a Review

NPPES record last updated: December 12, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Nicole M Baca Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE M BACA MD (NPI 1093077802) is an individual pediatric hematology-oncology provider in West Hollywood, California, licensed in California (A136037) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1093077802
Entity TypeIndividualFemale
Primary Taxonomy2080P0207X
Provider Legal NameDR. NICOLE M BACACredential: MD
Location Address8700 BEVERLY BLVDWest Hollywood, CA 90048-1804
Mailing AddressPo Box 512717Los Angeles, CA 90051-0717
Phone(310) 423-4471
Fax(310) 423-0145
Sole ProprietorNo
Enumeration DateJune 8, 2012
Last NPPES UpdateDecember 12, 2018
✔ NPI 1093077802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
License✔ Licensed in CA · A136037
Definition
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
Also ListedPediatricsTaxonomy 208000000X · License A136037 (CA)
8700 BEVERLY BLVD, West Hollywood, CA 90048
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Secondary Practice Locations 2

Location 12040 W Charleston Blvd Ste 504Las Vegas, NV 89102-2207 · Phone (702) 671-6437
Location 21201 W La Veta AveOrange, CA 92868-4203 · Phone (714) 509-4348

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole M Baca Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BERNICE LOUISE COLEMAN PH.D, ACNP-BC
Nurse Practitioner (Acute Care)
8700 BEVERLY BLVD, NORTH TOWER ROOM 6215
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-6178
DR. INGRID LEAH DOMBROWER M.D.
Psychiatry & Neurology (Psychiatry)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-2871
ELAINE WITTERT MSW
Social Worker (Clinical)
8700 BEVERLY BLVD, SUITE AC1002
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-3119
DR. KENAN MOHAMMED NADAR D.O.
Pediatrics
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-4451
HAE YOON GRACE CHOUNG MD
Pathology (Anatomic Pathology & Clinical Pathology)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-6623
CASEY DISTASO MD
Emergency Medicine
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-8780
CHIARA CASAS NP
Nurse Practitioner (Pediatrics)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-3277
PHILIP CHENG MD
Student in an Organized Health Care Education/Training Program
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-1682

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Baca's NPI number?

The NPI number for Nicole Baca is 1093077802. It was assigned to this individual provider in the NPPES registry on June 8, 2012.

Where is Nicole Baca located?

Nicole Baca practices at 8700 Beverly Blvd, West Hollywood, CA 90048. The listed phone number is (310) 423-4471.

What is Nicole Baca's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

Is Nicole Baca enrolled in Medicare?

Yes. Nicole Baca is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Nicole Baca was last updated on December 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.