BAYSTATE MEDICAL PRACTICES, INC. (NPI# 1336205582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336205582 |
| Entity Type | Organization |
| Organization Name | BAYSTATE MEDICAL PRACTICES, INC. |
| Other Organization Name | BMP, DEPT OF OBGYN |
| Practice Address |
759 Chestnut St Springfield MA 01199-1001 |
| Mailing Address |
280 Chestnut St 2nd Floor Springfield MA 01199-1000 |
| Practice Telephone | 4137945700 |
| Practice Fax Number | 4137941629 |
| Mailing Telephone | 4137945700 |
| Mailing Fax Number | 4137941629 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2014-02-26 |
| Authorized Official Name | RANDALL L VAILL JR. (MANAGER PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 4137947976 |
| Is Organization Subpart | Y |
| Parent Organization Name | BAYSTATE MEDICAL PRACTICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
Allopathic & Osteopathic Physicians | ||
| N | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 367A00000X | Advanced Practice Midwife | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| BMP, Dept of OBGYN | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982761094 | Baystate Medical Practices, Inc. | Family Medicine | 759 Chestnut St, Springfield, MA 01199-1001 | 2007-01-02 |
| 1366509473 | Baystate Medical Practices, Inc. | Surgery | 759 Chestnut St, Springfield, MA 01199-1001 | 2007-01-02 |
| Street Address |
759 CHESTNUT ST |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01199-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578569828 | Diane L Dietzen | Internal Medicine | 759 Chestnut St, Springfield, MA 01199-1619 | 2005-06-22 |
| 1689274987 | Michele Lee Houghton | Registered Nurse | 759 Chestnut St, Springfield, MA 01199-1001 | 2020-10-27 |
| 1922612621 | Justine Trowbridge | Physician Assistant | 759 Chestnut St, Springfield, MA 01199-2225 | 2020-09-01 |
| 1316550221 | Vi Thuy Do | Registered Nurse | 759 Chestnut St, Springfield, MA 01199-1001 | 2020-08-29 |
| 1689282519 | Anum Fatima | Student in an Organized Health Care Education/Training Program | 759 Chestnut St, Springfield, MA 01199-0001 | 2020-07-16 |
| 1033737432 | Subahana Aboobucker | Student in an Organized Health Care Education/Training Program | 759 Chestnut St, Springfield, MA 01199-0001 | 2020-07-12 |
| 1083232003 | Yunika Burgos Depalma | Physician Assistant | 759 Chestnut St, Springfield, MA 01199-0001 | 2020-07-07 |
| 1437774858 | Yelisei Murauski | Physician Assistant | 759 Chestnut St, Springfield, MA 01107-1619 | 2020-06-11 |
| 1073138517 | Zaid Obaida | Student in an Organized Health Care Education/Training Program | 759 Chestnut St, Springfield, MA 01199-0001 | 2020-06-10 |
| 1265054886 | Rachel Christine Schmidt | Student in an Organized Health Care Education/Training Program | 759 Chestnut St, Springfield, MA 01199-0001 | 2020-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194211227 | Alice Perman Leveston | Social Worker | 759 Chestnut St # S2660, Springfield, MA 01199 | 2018-07-01 |
| 1043732415 | Calvin Keith Craig | Student in an Organized Health Care Education/Training Program | Baystate Medical Center 759 Chestnut Street, Springfield, MA 01199 | 2017-07-07 |
| 1598026494 | Yesenia Greeff | Internal Medicine | 3300 Main St Ste 3a, Springfield, MA 01199 | 2012-06-06 |
| 1912231903 | Abistanand Ankam | Anesthesiology | 759 Chestnut St Department of Anesthesia, Baystate Medical Center, Holyoke, MA 01199 | 2009-09-24 |
| 1205099553 | Ejaz Khalid | Internal Medicine | 759 Chest Nut Street, Department of Internal Medicine Attn Linda Baillargeon, Springfield, MA 01199 | 2008-07-08 |
| 1184817926 | Asha Thomas | Pediatrics | 3300 Main Street 4th Floor, Suite A&b, Springfield, MA 01199 | 2007-08-24 |
| 1730381435 | Vicki Weld | Social Worker | 3300 Main Street, Suite 4a, Springfield, MA 01199 | 2007-06-04 |
| 1699976266 | Jim Maloney | Physical Therapist | 360 Birnie Avenue, Springfield, MA 01199 | 2007-05-30 |
| 1881780690 | Lawrence C Peters | Psychiatry & Neurology | 759 Chestnut Street S5632, Springfield, MA 01199 | 2006-10-05 |
| 1366460222 | Stephen A Luippold | Registered Nurse | 759 Chesnut Street, S2676, Springfield, MA 01199 | 2006-07-18 |
| Find all providers in zip 01199 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134578628 | Lauren L.o. Diskin | Obstetrics & Gynecology | 2135 S Fremont Ave Ste 200, Springfield, MO 65804-2239 | 2016-06-06 |
| 1851706824 | Terah Louise Holland | Obstetrics & Gynecology | 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 | 2014-06-27 |
| 1659799161 | Elizabeth A. Otmaskin | Obstetrics & Gynecology | 3455 Main Street Suite C, Baysttate Ob Gyn Group Inc, Springfield, MA 01107 | 2014-04-01 |
| 1821433368 | Jeffrey Alan Davis | Obstetrics & Gynecology | 522 Northcrest Drive, Northcrest Center for Women's Health, Springfield, TN 37172 | 2013-05-09 |
| 1134473457 | New Beginnings, Ob/gyn, LLC | Obstetrics & Gynecology | 193 Mountain Ave, Springfield, NJ 07081-1755 | 2012-11-08 |
| 1104196641 | Henry Olugbenga Adekola | Obstetrics & Gynecology | 415 N 9th St # 6w30, Springfield, IL 62702-5303 | 2011-12-30 |
| 1043506801 | Megan Christine Rooney Thompson | Obstetrics & Gynecology | 3850 S National Ave Ste 400, Springfield, MO 65807-5287 | 2011-06-21 |
| 1891008074 | Shanon M. Tuter | Obstetrics & Gynecology | 3231 S National Ave Ste 250, Springfield, MO 65807-7304 | 2010-07-16 |
| 1730415407 | Carl Lance De Fronzo | Obstetrics & Gynecology | 216 Short Hills Ave, Springfield, NJ 07081-1010 | 2009-10-30 |
| 1083887582 | Myron Seymour Soled | Obstetrics & Gynecology | 71 Tree Top Drive, Springfield, NJ 07081 | 2008-04-07 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01199 |
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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.