BAYSTATE MEDICAL PRACTICE, INC (NPI# 1770750226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770750226 |
| Entity Type | Organization |
| Organization Name | BAYSTATE MEDICAL PRACTICE, INC |
| Other Organization Name | BAYSTATE/BMP ART/IVF |
| Practice Address |
759 Chestnut St Springfield MA 01199-1001 |
| Mailing Address |
280 Chestnut St 2nd Floor Springfield MA 01199-1000 |
| Practice Telephone | 4137945700 |
| Mailing Telephone | 4137945700 |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2010-10-14 |
| Authorized Official Name | DEBRA A. CREMONTI (DIRECTOR MEDICAL STAFF SERVICES) |
| Authorized Official Telephone | 4137945508 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BC BS GROUP NUMBER | M16667 | 01 |
| Other Name | Type Code |
|---|---|
| Baystate/BMP ART/IVF | Doing Business As Name - Organization |
| 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 |
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| 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 |
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| Taxonomy Code | 207VE0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Reproductive Endocrinology |
| An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |
| 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 |
|---|---|---|---|---|
| 1609833979 | Phillip Charles Galle | Obstetrics & Gynecology | 340 W Miller Street, Springfield, IL 62702 | 2006-04-28 |
| 1952513483 | Reproductive Endocrinology Associates, S.c. | Obstetrics & Gynecology | 340 W Miller Street, Springfield, IL 62702 | 2007-05-04 |
| 1336205582 | Baystate Medical Practices, Inc. | Obstetrics & Gynecology | 759 Chestnut St, Springfield, MA 01199-1001 | 2006-12-29 |
| 1619063310 | Daniel R Grow | Obstetrics & Gynecology | 3300 Main St, 4th Fl, Springfield, MA 01107-1112 | 2006-10-04 |
| 1790885804 | Kelly A Lynch | Obstetrics & Gynecology | 3300 Main St, 4th Floor, Springfield, MA 01107-1112 | 2006-09-25 |
| 1821017450 | Cynthia K Sites | Obstetrics & Gynecology | 3300 Main Street, 4th Floor, Springfield, MA 01107-1112 | 2006-07-18 |
| 1669406302 | Donna L O'shea | Obstetrics & Gynecology | 3300 Main St, 4th Floor, Springfield, MA 01199-1619 | 2006-07-10 |
| 1174581680 | Mary Ann Mcrae | Obstetrics & Gynecology | 340 W Miller Street, Springfield, IL 62702 | 2006-05-03 |
| 1194711374 | Halina Wiczyk | Obstetrics & Gynecology | 3300 Main St, 4th Floor, Springfield, MA 01107-1112 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154851368 | Crmb Physician Group Pllc | Obstetrics & Gynecology | 300 Boylston, Newton Corner, MA 02459 | 2017-06-20 |
| 1295918027 | Samuel Allen Pauli | Obstetrics & Gynecology | 450 Bedford St Ste 1000, Lexington, MA 02420-1520 | 2007-12-16 |
| 1669663662 | Sander S Shapiro | Obstetrics & Gynecology | 18 Duck Pond Road, West Tisbury, MA 02575 | 2007-08-05 |
| 1568556702 | Robert Howe, Md, PC | Obstetrics & Gynecology | 281 Maple St, East Longmeadow, MA 01028-2712 | 2006-10-03 |
| 1013022078 | Charles-chidi W Obasiolu | Obstetrics & Gynecology | Ctr for Fertility & Repro Hlth, 133 Brookline Ave, Boston, MA 02215 | 2006-08-20 |
| 1942243076 | Alison E Zimon | Obstetrics & Gynecology | 300 Boylston Street, Ccrm Boston, Suite 300, Newton Corner, MA 02459 | 2006-06-14 |
| 1962459131 | Dan Tulchinsky | Obstetrics & Gynecology | 1 Forbes Rd., Reproductive Science Ctr., Lexington, MA 02421 | 2006-05-31 |
| 1992742191 | Kim L Thornton | Obstetrics & Gynecology | 130 2d Avenue, Boston Ivf - The Waltham Center, Waltham, MA 02451 | 2006-05-31 |
| 1154375038 | Steven Robert Bayer | Obstetrics & Gynecology | 1 Brookline Pl Ste 302, Boston Ivf - The Boston Center, Brookline, MA 02445-7237 | 2006-05-22 |
| 1255391256 | John H Derry | Obstetrics & Gynecology | One Forbes Road, Lexington, MA 02421 | 2006-03-24 |
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| 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.