Physician Compare National (NPI:1508967639)

HEALTHCARE PROVIDER: LARRY L BAKER M.D., D.D.S.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1508967639
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971594201
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20041217000706
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BAKER
	Individual professional last name
Provider First Name	LARRY
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	MAYO MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	MAXILLOFACIAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ORAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ORAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	501 W 9TH ST
	Group Practice or individual's line 1 address
City	HASTINGS
	Group Practice or individual's city
State	NE
	Group Practice or individual's state
Zip Code	689013908
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	280032
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MARY LANNING HEALTHCARE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M