MARYLOU BACA
NPI 1629938873
Nurse Practitioner in Santa Fe, NM

Q: What is Marylou Baca's NPI number?

The NPI number for Marylou Baca is 1629938873. It was assigned to this individual provider in the NPPES registry on November 12, 2025.

Q: What is Marylou Baca's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Marylou Baca was last updated on November 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.

Active since November 12, 2025PECOS Enrolled

707 PASEO DE PERALTA, SANTA FE, NM 87501(505) 989-8707(505) 989-3536 Get Directions Write a Review

NPPES record last updated: November 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Marylou Baca NPPES

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

MARYLOU BACA (NPI 1629938873) is an individual nurse practitioner in Santa Fe, New Mexico, licensed in New Mexico (85944) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS, is affiliated with Christus St Vincent Regional Medical Center, and maintains a secondary practice location in Rio Rancho.

NPPES Registry Identity

NPI1629938873

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMARYLOU BACA

Location Address707 PASEO DE PERALTASanta Fe, NM 87501-1922

Mailing Address707 Paseo De PeraltaSanta Fe, NM 87501-1922 · (505) 577-4543 · Fax (505) 989-3536

Phone(505) 989-8707

Fax(505) 989-3536

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateNovember 12, 2025

NPPES CertifiedNovember 12, 2025

✔ NPI 1629938873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NM · 85944

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

707 PASEO DE PERALTA, Santa Fe, NM 87501

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Secondary Practice Location 1

Location 17555 Enchanted Hills Blvd NE Ste 104Rio Rancho, NM 87144-8625 · Phone (505) 771-9833 · Fax (505) 771-9834

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marylou Baca is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID345734554

PECOS Enrollment IDI20251215000960

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.

Hospital Affiliations CMS Care Compare

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

Christus St Vincent Regional Medical Center

Acute Care Hospitals · Santa Fe, NM

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number320002

Location455 St Michael's DriveSanta Fe, NM 87505 · Santa Fe County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87501 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

$84.79 typical visit price

range $54.26 – $166.80

Typical copayment $21.19 (range $13.56 – $41.70)

Most-billed visit code 99203

Established Patient

$96.38 typical visit price

range $17.00 – $135.35

Typical copayment $24.09 (range $4.25 – $33.83)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

MS. LESA DEANNE FRAKER MD PHD

Emergency Medicine