SAMANTHA HALEY BACA
NPI 1851120463
Nurse Practitioner - Family in Port Jefferson, NY
About Samantha Haley Baca NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMANTHA HALEY BACA (NPI 1851120463) is an individual family provider in Port Jefferson, New York, licensed in New York (354678-01) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS, is affiliated with John T Mather Memorial Hospital Of Port Jefferson, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
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
Samantha Haley Baca 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
John T Mather Memorial Hospital Of Port Jefferson
Acute Care Hospitals · Port Jefferson, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 11777 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PORT JEFFERSON, NY 11777
PORT JEFFERSON, NY 11777
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 Samantha Baca's NPI number?
The NPI number for Samantha Baca is 1851120463. It was assigned to this individual provider in the NPPES registry on July 31, 2024.
Where is Samantha Baca located?
Samantha Baca practices at 125 Oakland Ave Ste 203, Port Jefferson, NY 11777. The listed phone number is (631) 978-7590.
What is Samantha Baca's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Samantha Baca enrolled in Medicare?
Yes. Samantha Baca 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.
Is Samantha Baca affiliated with any hospitals?
According to CMS data, Samantha Baca is affiliated with John T Mather Memorial Hospital Of Port Jefferson.
When was this NPI record last updated?
The NPPES record for Samantha Baca was last updated on December 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.
# Samantha Haley Baca · NPI 1851120463
Family physician in Port Jefferson, New York. Individual provider, active in the CMS NPPES registry since July 31, 2024.
## Identity
- **NPI:** 1851120463 (Entity type: Individual)
- **Enumerated:** July 31, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 354678-01 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 125 OAKLAND AVE STE 203, Port Jefferson, NY 11777-2130
- **Phone:** (631) 978-7590
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** December 7, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1851120463) · Data from the CMS NPPES public registry.