SPRINGFIELD FAMILY PRACTICE, INC (NPI# 1659389237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659389237 |
| Entity Type | Organization |
| Organization Name | SPRINGFIELD FAMILY PRACTICE, INC |
| Practice Address |
125 Liberty St Suite 408 Springfield MA 01103-1114 |
| Mailing Address |
59 Temple Pl Suite 612 Boston MA 02111-1307 |
| Practice Telephone | 4137816410 |
| Practice Fax Number | 4137816625 |
| Mailing Telephone | 6172649764 |
| Mailing Fax Number | 6172649763 |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PUNYAMURTULA S KISHORE (PRESIDENT) |
| Authorized Official Telephone | 6177384640 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SPRINGFIELD FAMILY PRACTICE, INC. | 59 Temple Place, Suite 612, Boston, MA 02111 |
| Street Address |
125 LIBERTY ST SUITE 408 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01103-1114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619977402 | Peter T Demos | Dermatology | 125 Liberty St, Springfield, MA 01103-2961 | 2005-07-22 |
| 1881206241 | Carl Amyas Taylor | Counselor | 125 Liberty St, Springfield, MA 01103-1114 | 2020-08-18 |
| 1346892437 | L&l Life Enrichment Center LLC | Psychologist | 125 Liberty St, Springfield, MA 01103-1114 | 2019-07-10 |
| 1912440892 | Metrocare of Springfield | Nursing Care | 125 Liberty St, Suite 404, Springfield, MA 01103-1114 | 2016-11-28 |
| 1730622614 | Metrocare of Springfield | Custodial Care Facility | 125 Liberty St, Springfield, MA 01103-1114 | 2016-11-28 |
| 1215384409 | Adult and Geriatric Medicine Partners, L.L.C. | Family Medicine | 125 Liberty St, Suite 403, Springfield, MA 01103-1114 | 2016-05-18 |
| 1457717795 | Metrocare of Springfield LLC | In Home Supportive Care | 125 Liberty St, Suite 404, Springfield, MA 01103-1109 | 2015-12-31 |
| 1457729741 | Right Choice Health Group LLC | Clinic/Center | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-09-03 |
| 1730557018 | Mindcare Agency PC | Community/Behavioral Health | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-09-03 |
| 1427431402 | Nicole Dacampo | Registered Nurse | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336790609 | Mahmoud Al Homsi | Dentist | 41 Taylor St. 4th Fl, Springfield, MA 01103 | 2019-09-26 |
| 1427521749 | Pedro Cruz | Student in an Organized Health Care Education/Training Program | 95 Frank B Murray, Springfield, MA 01103 | 2019-01-09 |
| 1003325010 | Amber Lynn Chisholm | Counselor | 130 Maple St., Springfield, MA 01103 | 2017-09-21 |
| 1750737391 | Mande' Counseling | Community/Behavioral Health | 1365 Main St Suite 401, Springfield, MA 01103 | 2016-05-13 |
| 1528467248 | Amanda M Galloway | Physician Assistant | 1038-1050 Main St, Springfield, MA 01103 | 2014-08-19 |
| 1114326113 | Anne Marie Belinda | Nurse Practitioner | 1049 Main St., Springfield, MA 01103 | 2014-08-15 |
| 1538575295 | Sunrise Behavioral Health Clinic, LLC | Clinic/Center | 95 Frank B. Murray Street, Springfield, MA 01103 | 2014-07-02 |
| 1548675093 | Jessica Lynn Pasalacqua | Dietitian, Registered | 870 Main St., Springfield, MA 01103 | 2014-06-24 |
| 1003220443 | Ivan Rosario | Counselor | 1695 Main St Ste400, Springfield, MA 01103 | 2014-06-13 |
| 1275964769 | Leeandrew Rick Wilson | Counselor | 1695 Main St., Springfield, MA 01103 | 2013-12-09 |
| Find all providers in zip 01103 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802592 | Community Health and Wellness Services, Inc. | Family Medicine | 312 Memorial Park Dr, Springfield, PA 19064-1714 | 2020-08-22 |
| 1649815796 | 180 Health Lifestyle Wellness Centers | Family Medicine | 1936 S Glenstone Ave, Springfield, MO 65804-2305 | 2019-11-13 |
| 1790337988 | Aminat Ogun | Family Medicine | 520 N 4th St # 62702, Springfield, IL 62702-5238 | 2019-07-09 |
| 1770076622 | Thomas John Schumann | Family Medicine | 1260 E. Woodlawn Ave, Suite 200, Springfield, PA 19064-3988 | 2018-06-14 |
| 1134648959 | Patricia Derges | Family Medicine | 3259 E Sunshine St Ste Aa, Springfield, MO 65804-2114 | 2017-09-12 |
| 1740704667 | Mercy Management of Sepa | Family Medicine | 1001 Baltimore Pike Ste 109, Springfield, PA 19064-2852 | 2017-08-02 |
| 1083134902 | Trevor Conner | Family Medicine | 1423 N Jefferson Ave, B100, Springfield, MO 65802 | 2017-06-21 |
| 1790215853 | Vincent Marchese | Family Medicine | 1260 E Woodland Ave Ste 200, Springfield, PA 19064-3956 | 2017-06-12 |
| 1184152100 | Canaan Arceneaux | Family Medicine | 1001 Baltimore Pike Ste 106, Springfield, PA 19064-2800 | 2017-06-03 |
| 1063943587 | Cody Stark Rogers | Family Medicine | 1423 N Jefferson Ave # A100, Springfield, MO 65802-1988 | 2017-03-26 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01103 |
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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.