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DR. GREGORY L. BAKER M.D.
NPI 1205929155
Otolaryngology in Ashland, KY

Active since October 02, 2006PECOS EnrolledAccepts Medicare Assignment
82.94/100
CMS Quality Rating
613 23RD ST STE 420, ASHLAND, KY 41101(606) 325-8561(606) 325-3591 Get Directions Write a Review

NPPES record last updated: November 18, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 18, 2021, Dec 3, 2018 (2 updates tracked since 2018).

About Dr. Gregory L. Baker M.d. NPPES

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

DR. GREGORY L. BAKER M.D. (NPI 1205929155) is an individual otolaryngology provider in Ashland, Kentucky, licensed in Kentucky (33745) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with King's Daughters' Medical Center, and is a graduate of Other (1978).

NPPES Registry Identity

NPI1205929155
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. GREGORY L. BAKERCredential: M.D.
Location Address613 23RD ST STE 420Ashland, KY 41101-2885
Mailing AddressPo Box 2379Ashland, KY 41105-2379 · (606) 408-4000
Phone(606) 325-8561
Fax(606) 325-3591
Sole ProprietorYes
Medical School CMSOtherGraduated 1978
Enumeration DateOctober 2, 2006
Last NPPES UpdateNovember 18, 20212 updates tracked since enumeration
NPPES CertifiedNovember 18, 2021
✔ NPI 1205929155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in KY · 33745
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
613 23RD ST STE 420, Ashland, KY 41101
Open in Google Maps ↗

Other Identifiers 4

Medicaid2108918OH
OtherP00885633KY · Rr Medicare
Medicaid0100936000WV
Medicaid64373459KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gregory L. Baker M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395711592
PECOS Enrollment IDI20040909000044, I20101108000873
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.

Medicare Billing Reassignment

Medicare enrollment records show Gregory Baker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kings Daughters Medical Specialties Inc
Same address
Orthopaedic Surgery
613 23RD ST STE G30
Ashland, KY 41101
  • Reassigned Medicare billing, Kentucky and Ohio enrollments
  • 531 clinicians in this Medicare group
NPI 1053643981 (606) 327-0036

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
182 services107 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
136 services95 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
112 services70 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
89 services89 patients
Test to assess middle ear function 92567
A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.
78 services58 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
75 services68 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

King's Daughters' Medical Center

Acute Care Hospitals · Ashland, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180009
Location2201 Lexington AvenueAshland, KY 41101 · Boyd County
Emergency services

Southern Ohio Medical Center

Acute Care Hospitals · Portsmouth, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number360008
Location1805 27th StreetPortsmouth, OH 45662 · Scioto County
Emergency services Birthing friendly

Kings Daughters Medical Center Ohio

Acute Care Hospitals · Portsmouth, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number360361
Location1901 Argonne RoadPortsmouth, OH 45662 · Scioto County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.94/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.01
Promoting Interoperability100
Improvement Activities40
Cost65.57

Other Providers at the Same Location NPPES 2

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

JON A. BRINKMAN D.O.
Otolaryngology (Plastic Surgery within the Head & Neck)
613 23RD ST STE 420
ASHLAND, KY 41101
Boyd County (606) 836-3681
DR. WILLIAM JOHN VAN BENEDEN D.O.
Otolaryngology
613 23RD ST STE 420
ASHLAND, KY 41101
Boyd County (606) 325-8561

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 Gregory Baker's NPI number?

The NPI number for Gregory Baker is 1205929155. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Gregory Baker located?

Gregory Baker practices at 613 23rd St Ste 420, Ashland, KY 41101. The listed phone number is (606) 325-8561.

What is Gregory Baker's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Gregory Baker enrolled in Medicare?

Yes. Gregory Baker is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Gregory Baker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Baker reassigns Medicare benefits to Kings Daughters Medical Specialties Inc (Ashland, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gregory Baker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gregory Baker accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Gregory Baker as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gregory Baker affiliated with any hospitals?

According to CMS data, Gregory Baker is affiliated with King's Daughters' Medical Center, Southern Ohio Medical Center and Kings Daughters Medical Center Ohio.

When was this NPI record last updated?

The NPPES record for Gregory Baker was last updated on November 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.