BAKER COMMUNITY HEALTH CENTER INC – Emergency Medicine Physician, NPI 1396807319
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for BAKER COMMUNITY HEALTH CENTER INC
Ed Fraser Memorial Hospital, 159, North 3rd Street, Macclenny, Baker County, Florida, 32063, United States
MACCLENNY, FL 320632103
Phone: (904) 259-3151
Fax: (904) 259-3279
Mailing address matches the actual address.
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: 2025-03-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (800 days ago).
Enrollment records
29
Earliest due date
2024-03-31
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 |
|---|---|---|---|---|
| O20070728000111 | O | Clinic/Group Practice | FL | TBD |
| O20190129003939 | O | Clinic/Group Practice | AZ | 2025-12-31 |
| O20190130002431 | O | Clinic/Group Practice | HI | 2024-09-30 |
| O20190201002544 | O | Clinic/Group Practice | OR | 2025-12-31 |
| O20190206001923 | O | Clinic/Group Practice | KS | TBD |
| O20190206002671 | O | Clinic/Group Practice | MO | 2026-01-31 |
| O20190206003357 | O | Clinic/Group Practice | CA | 2026-02-28 |
| O20190214001534 | O | Clinic/Group Practice | TX | 2026-02-28 |
| O20190215000652 | O | Clinic/Group Practice | PA | 2026-03-31 |
| O20190219001227 | O | Clinic/Group Practice | MS | 2026-04-30 |
| O20190220002431 | O | Clinic/Group Practice | OH | 2026-05-31 |
| O20190222000125 | O | Clinic/Group Practice | MA | 2026-05-31 |
| O20190222001484 | O | Clinic/Group Practice | IL | 2026-06-30 |
| O20190227000778 | O | Clinic/Group Practice | CO | 2026-06-30 |
| O20190228000200 | O | Clinic/Group Practice | RI | 2026-07-31 |
| O20190311001589 | O | Clinic/Group Practice | NC | 2026-08-31 |
| O20190311002541 | O | Clinic/Group Practice | TN | 2026-09-30 |
| O20190312003125 | O | Clinic/Group Practice | VA | 2024-03-31 |
| O20190318000272 | O | Clinic/Group Practice | SC | 2026-10-31 |
| O20190318001931 | O | Clinic/Group Practice | MI | TBD |
| O20190327002885 | O | Clinic/Group Practice | GA | TBD |
| O20190829000103 | O | Clinic/Group Practice | CT | TBD |
| O20191003002499 | O | Clinic/Group Practice | NY | TBD |
| O20240805004198 | O | Clinic/Group Practice | AL | TBD |
| O20240828001228 | O | Clinic/Group Practice | MT | TBD |
| O20240913000213 | O | Clinic/Group Practice | ID | TBD |
| O20250128002247 | O | Clinic/Group Practice | UT | TBD |
| O20250130003226 | O | Clinic/Group Practice | NH | TBD |
| O20250318000350 | O | Clinic/Group Practice | NJ | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 32063)
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