DR. JAMES DOUGLAS BAKER MD
NPI 1588879860
Orthopaedic Surgery - Hand Surgery in Edgewood, KY

Active since May 11, 2007PECOS EnrolledAccepts Medicare Assignment
90.38/100
CMS Quality Rating
560 S LOOP RD, EDGEWOOD, KY 41017(859) 301-2663(859) 301-0655 Get Directions Write a Review

NPPES record last updated: February 15, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 15, 2023, Aug 2, 2021, Feb 3, 2016 (3 updates tracked since 2016).

About Dr. James Douglas Baker Md NPPES

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

DR. JAMES DOUGLAS BAKER MD (NPI 1588879860) is an individual hand surgery provider in Edgewood, Kentucky, licensed in Kentucky (43042) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth Ft Thomas, and is a graduate of University Of Louisville School Of Medicine (2003).

NPPES Registry Identity

NPI1588879860
Entity TypeIndividualMale
Primary Taxonomy207XS0106X
Provider Legal NameDR. JAMES DOUGLAS BAKERCredential: MD
Location Address560 S LOOP RDEdgewood, KY 41017-3405
Mailing Address560 S Loop RdEdgewood, KY 41017-3405 · (859) 301-2663 · Fax (859) 301-0655
Fax(859) 301-0655
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2003
Enumeration DateMay 11, 2007
Last NPPES UpdateFebruary 15, 20233 updates tracked since enumeration
NPPES CertifiedFebruary 15, 2023
NPI 1588879860 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XS0106X
License Licensed in KY · 43042
Definition
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 43042 (KY)
560 S LOOP RD, Edgewood, KY 41017

Other Identifiers 2

Medicaid7100094600KY
Medicaid300022147IN

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. James Douglas Baker Md 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 ID1557417771
PECOS Enrollment IDI20190207000184
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.

Areas of Expertise CMS Part B claims 18

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.

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.
144 services143 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 services125 patients
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702
This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.
135 services60 patients
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.
107 services84 patients
X-ray of finger, minimum of 2 views 73140
An X-ray of the finger involves capturing images of your finger from at least two different angles. This non-invasive procedure helps in visualizing the bones and joints, aiding in the diagnosis of fractures, infections, or other abnormalities. Minimal discomfort may be experienced.
106 services70 patients
X-ray of hand, minimum of 3 views 73130
An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.
90 services60 patients

Hospital Affiliations CMS Care Compare 4

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

St Elizabeth Ft Thomas

Acute Care Hospitals · Fort Thomas, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180001
Location85 North Grand AvenueFort Thomas, KY 41075 · Campbell County
Emergency services

St Elizabeth Edgewood

Acute Care Hospitals · Edgewood, KY
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180035
Location1 Medical Village DriveEdgewood, KY 41017 · Kenton County
Emergency services Birthing friendly

Jewish Hospital & St Mary's Healthcare

Acute Care Hospitals · Louisville, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180040
Location200 Abraham Flexner WayLouisville, KY 40202 · Jefferson County
Emergency services

St Elizabeth Florence

Acute Care Hospitals · Florence, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180045
Location4900 Houston RoadFlorence, KY 41042 · Boone County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41017 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
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.

90.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.76
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
81%345 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%396 patients5/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
99%203 patients5/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Dynamic adjustable forearm pronation/supination device, includes soft interface material E1802
DME-Other DME · category DE000N
1 supplier18 claims18 services$253.87 avg. paid by Medicare
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908
DME-Orthotic Devices · category DF000N
1 supplier23 claims29 services$42.12 avg. paid by Medicare
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf L3924
DME-Orthotic Devices · category DF000N
1 supplier17 claims21 services$60.26 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Podiatrist
560 S LOOP RD
EDGEWOOD, KY 41017
Physician Assistant
560 S LOOP RD
EDGEWOOD, KY 41017
Orthopaedic Surgery (Sports Medicine)
560 S LOOP RD
EDGEWOOD, KY 41017
Orthotist
560 S LOOP RD
EDGEWOOD, KY 41017
Physician Assistant
560 S LOOP RD
EDGEWOOD, KY 41017
Physician Assistant (Surgical)
560 S LOOP RD
EDGEWOOD, KY 41017
Physical Therapist
560 S LOOP RD
EDGEWOOD, KY 41017
Orthopaedic Surgery
560 S LOOP RD
EDGEWOOD, KY 41017

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 James Baker's NPI number?

The NPI number for James Baker is 1588879860. It was assigned to this individual provider in the NPPES registry on May 11, 2007.

Where is James Baker located?

James Baker practices at 560 S Loop Rd, Edgewood, KY 41017. The listed phone number is (859) 301-2663.

What is James Baker's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Is James Baker enrolled in Medicare?

Yes. James 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.

What insurance does James 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 James 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 James Baker affiliated with any hospitals?

According to CMS data, James Baker is affiliated with St Elizabeth Ft Thomas, St Elizabeth Edgewood, Jewish Hospital & St Mary's Healthcare and St Elizabeth Florence.

When was this NPI record last updated?

The NPPES record for James Baker was last updated on February 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.