DR. MARK A JACKOWITZ (NPI# 1508851411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508851411 |
| Entity Type | Individual |
| Full Name | DR. MARK A JACKOWITZ |
| Credential | M.D. |
| Practice Address |
3640 Main St Suite 205 Springfield MA 01107-1145 |
| Practice Telephone | 4137397367 |
| Practice Fax Number | 4137372686 |
| Mailing Telephone | 4137397367 |
| Mailing Fax Number | 4137372686 |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2014-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 57126 | MA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | CONNECTICARE | 032587 | 01 |
| MA | HEALTH NEW ENGLAND | 13334 | 01 |
| MA | RAILROAD MEDICARE | 180012328 | 01 |
| MA | OXFORD HEALTH PLANS | P1500300 | 01 |
| MA | CIGNA | 0034216003 | 01 |
| MA | HARVARD PILGRIM | 150664 | 01 |
| MA | MASS BLUE SHIELD | J06214 | 01 |
| MA | CONNECTICUT BLUE SHIELD | 010057126MA01 | 01 |
| MA | AETNA GROUP NO. | 0115328 | 01 |
| MA | UNITED HEALTH CARE | 0804490 | 01 |
| Street Address |
3640 MAIN ST SUITE 205 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1598057556 | Sandy L Chambers | Technician/Technologist | 3640 Main St, Suite 206, Springfield, MA 01107-1145 | 2011-05-10 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1396146411 | Colin Bailey | Specialist | 155 S Tuttle Rd, Springfield, OH 45505-1560 | 2014-09-08 |
| 1659771350 | Ronnie L. Jackson Md | Specialist | 496 Northcrest Dr, Springfield, TN 37172-3972 | 2014-08-29 |
| 1659781136 | Ashley Foucha | Specialist | 1342 E Primrose St Ste A, Springfield, MO 65804-4224 | 2014-05-05 |
| 1225452881 | Elizabeth Creps | Specialist | 1623 21st St Ste B, Springfield, OR 97477-3417 | 2014-02-18 |
| 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.