MS. JEANNIE MARIE BACA – Social Worker, NPI 1174872147

MS. JEANNIE MARIE BACA is a healthcare provider. based in Dorchester, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 119874 (MA). The NPI Number for MS. JEANNIE MARIE BACA is 1174872147

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MS. JEANNIE MARIE BACA
NPI
1174872147
Phone
(617) 825-9660
Address
637 Washington St
Enumeration Date
5 September 2012
Last Update Date
17 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6178259660
Graduation Year
2013 (13 years ago)
PAC ID
9739462979
Group Practice PAC ID
8123013869
Professional Enrollment ID
I20170213002124
Address ID
MA021243510DO637XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:13State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

Provider Addresses for MS. JEANNIE MARIE BACA

  • 637 Washington St

    Dorchester, MA 021243510

    Phone: (617) 825-9660

    Fax: (617) 288-7898

    Type: Location

  • 435 WARREN ST

    ROXBURY, MA 021191833

    Phone: (617) 442-7400

    Type: Location

  • 637 WASHINGTON ST

    DORCHESTER, MA 021243510

    Phone: (617) 825-9660

    Fax: (617) 288-7898

    Type: Mailing

  • 8 ASTICOU RD

    APARTMENT 2

    JAMAICA PLAIN, MA 021303517

    Phone: (774) 212-1635

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-02-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170213002124IClinical Social WorkerMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02124)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8123013869View full group profile

Reviews

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Frequently asked questions

How do I look up MS. JEANNIE MARIE BACA by NPI?
Use NPI 1174872147 when you need to reference MS. JEANNIE MARIE BACA in forms, claims, or directories.
Is MS. JEANNIE MARIE BACA active in the national directory?
MS. JEANNIE MARIE BACA's public NPI profile is in an active state.
What kind of provider is MS. JEANNIE MARIE BACA?
The page reflects Social Worker for MS. JEANNIE MARIE BACA. Clinical services aligned with this taxonomy classification.
What location metadata exists for MS. JEANNIE MARIE BACA?
The page summarizes Dorchester, Massachusetts for MS. JEANNIE MARIE BACA; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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