ETHELBERT JACKSON BAKER (MD) – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1417922758
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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Profile Insights
NPPES metrics only — not quality of care.
395 THORACIC SURGERY in TX
Provider Addresses for ETHELBERT JACKSON BAKER (MD)
703 S Fleishel Ave Ste 5000
Tyler, TX 757012015
Phone: (903) 606-2992
Type: Location
1003 Bellefontaine Ave Ste 200
Lima, OH 458041803
Phone: (419) 227-7702
Fax: (419) 227-7991
Type: Location
272 HOSPITAL RD STE 6
CHILLICOTHE, OH 456019031
Phone: (740) 779-4222
Fax: (740) 779-4257
Type: Mailing
4439, Chillicothe Lancaster Road Southwest, Oakland, Fairfield County, Ohio, 43130, United States
SUITE 130
CHILLICOTHE, OH 456018207
Phone: (740) 779-4360
Fax: (740) 779-4369
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $179.
Total Amount is formed as General ($179) + Research ($0) + Ownership ($0) = $179.
Last reported payment date: 2024-09-05 • Largest payer in this snapshot: ABIOMED ($179).
Total Amount
$179
General + Research + Ownership
Payments
2
Total payment records
General Amount
$179
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABIOMED | $179 |
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: 2022-07-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050405000014 | I | Thoracic Surgery | OH | TBD |
| I20220701000097 | I | Thoracic Surgery | TX | TBD |
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.
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 75701)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | OH | |
| - | OH | |
| Family Practice | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Physician Assistant | OH | |
| Nurse Practitioner | OH | |
| Internal Medicine | OH | |
| Colorectal Surgery (Proctology) | OH | |
| Physician Assistant | OH |
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