PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C. (NPI# 1164733093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164733093 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, P.C. |
| Practice Address |
3640 Main St Suite 204 Springfield MA 01107-1145 |
| Practice Telephone | 4133042650 |
| Mailing Telephone | 4133042650 |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |
| Authorized Official Name | DR. SUSAN P GOODE (PRESIDENT) |
| Authorized Official Telephone | 3473273874 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
233855 | MA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PEDIATRIC GASTROENTEROLOGY AND NUTRITION GROUP, PC | 3640 Main St. Ste. 204, Springfield, MA 01107 |
| Street Address |
3640 MAIN ST SUITE 204 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508851411 | Mark A Jackowitz | Specialist | 3640 Main St, Suite 205, Springfield, MA 01107-1145 | 2005-09-16 |
| 1578093027 | Kathryn Ann Janikas | Physician Assistant | 3640 Main St, Springfield, MA 01107-1145 | 2017-06-18 |
| 1750818456 | Urologic Surgeons of New England, LLC | Urology | 3640 Main St, Suite 103, Springfield, MA 01107-1145 | 2017-05-12 |
| 1518324904 | Ryan Leigh Macdonald | Physician Assistant | 3640 Main St, Suite 302, Springfield, MA 01107-1145 | 2016-01-15 |
| 1750766853 | K. Francis Lee, M.d., P.C. | Surgery | 3640 Main St, Suite 302, Springfield, MA 01107-1145 | 2015-07-30 |
| 1053742098 | Michelle Sheehan | Nurse Practitioner | 3640 Main St, Suite 208, Springfield, MA 01107-1145 | 2013-12-02 |
| 1821435553 | Chelmsford Mri, P.C. | Radiology | 3640 Main St, Suite 101, Springfield, MA 01107-1145 | 2013-06-04 |
| 1134465545 | K. Francis Lee, M.d., P.C. | Surgery | 3640 Main St, Suite 302, Springfield, MA 01107-1145 | 2012-12-13 |
| 1831447820 | Gina Marie Lewis | Physician Assistant | 3640 Main St, Springfield, MA 01107-1145 | 2012-08-22 |
| 1376805978 | Paul Sciarretta | Technician/Technologist | 3640 Main St, Suite 206, Springfield, MA 01107-1145 | 2012-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740702547 | Domingo Nieves Jr. | Counselor | 2225 Main St., Springfield, MA 01107 | 2017-07-13 |
| 1801318266 | Denise Lawson | Counselor | 2257 Main Street, Springfield, MA 01107 | 2017-07-07 |
| 1568912491 | Trina Cysz | Nurse Practitioner | 101 Wason Avenue, Commonwealth Care Alliance, Springfield, MA 01107 | 2016-10-04 |
| 1609322262 | Toheeb Oladimeji Bakare | Counselor | 322 Birnie Avenue, Springfield, MA 01107 | 2016-09-01 |
| 1952701161 | Jalissa Sostre | Counselor | 32 Abbe Ave, Springfield, MA 01107 | 2014-08-26 |
| 1659799161 | Elizabeth A. Otmaskin | Obstetrics & Gynecology | 3455 Main Street Suite C, Baysttate Ob Gyn Group Inc, Springfield, MA 01107 | 2014-04-01 |
| 1205268885 | Catherine Matejcek Davies | Counselor | 246 Park Street, Springfield, MA 01107 | 2013-08-06 |
| 1750723268 | Jasdeep S. Badwal | Allergy & Immunology | 2 Medical Center Dr Ste 406, Springfield, MA 01107 | 2013-07-25 |
| 1255691846 | Medical Express Urgent Care Center, Co. Inc. | Physical Medicine & Rehabilitation | 438 Chestnut Street, Springfield, MA 01107 | 2012-05-17 |
| 1205166642 | Matthew R Kelley | Audiologist | 100 Wason, Suite 100, Springfield, MA 01107 | 2010-01-07 |
| Find all providers in zip 01107 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467691329 | Wael N. Sayej | Pediatrics | 50 Wason Ave Fl 1, Springfield, MA 01107-1280 | 2009-02-16 |
| 1265413009 | Anastasios G Angelides | Pediatrics | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2005-11-09 |
| 1164831186 | Eshan Michael Samuel | Pediatrics | 400 N 9th St, Springfield, IL 62702-5310 | 2014-08-04 |
| 1356652606 | Abhishek Watts | Pediatrics | 1965 S Fremont Ave, Suite 220, Springfield, MO 65804-2201 | 2010-07-01 |
| 1861620841 | Sarita Singhal | Pediatrics | 50 Wason Ave, Springfield, MA 01107-1274 | 2009-06-29 |
| 1841425568 | Prashanth Porayette | Pediatrics | 301 N 8th St, Suite Pav 4a, Springfield, IL 62701-1041 | 2009-05-26 |
| 1679629869 | Jody Nathaniel Hefner | Pediatrics | 3525 S National Ave Ste 210, Springfield, MO 65807 | 2007-01-28 |
| 1255354593 | Susan Pamela Goode | Pediatrics | 3640 Main St, Suite 204, Springfield, MA 01107-1145 | 2006-07-26 |
| 1356316715 | Zahangir Khaled | Pediatrics | 301 N 8th St, Suite Pav 4a, Springfield, IL 62701-1041 | 2006-02-21 |
| 1457333726 | Barry Zev Hirsch | Pediatrics | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2005-11-14 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.