BAYSTATE MEDICAL CENTER, INC (NPI# 1376967968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376967968 |
| Entity Type | Organization |
| Organization Name | BAYSTATE MEDICAL CENTER, INC |
| Practice Address |
3300 Main St Springfield MA 01107-1112 |
| Mailing Address |
Baystate Medical Center Inc 759 Chestnut Street Springfield MA 01199-0001 |
| Practice Telephone | 8558655432 |
| Practice Fax Number | 4134552985 |
| Mailing Telephone | 4137940000 |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MR. DENNIS CHALKE (SVP/CFO) |
| Authorized Official Telephone | 4137943290 |
| Is Organization Subpart | Y |
| Parent Organization Name | BAYSTATE MEDICAL CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
DS89897 | MA | Suppliers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 298 Carew St, Springfield, MA 011042316 | 8558655432 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BAYSTATE MEDICAL CENTER, INC. | 759 Chestnut St, Springfield, MA 01199-1001 |
| Connecticut Business Registrations | BAYSTATE MEDICAL CENTER, INC. | 759 Chestnut Street, Springfield, MA 01199 |
| Street Address |
3300 MAIN ST |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144226382 | James Kuo Chang Wang | Obstetrics & Gynecology | 3300 Main St, 4th Floor, Suite D, Springfield, MA 01107-1112 | 2005-06-22 |
| 1225639131 | Rachel M Carr | Nurse Practitioner | 3300 Main St, Springfield, MA 01107-1112 | 2020-11-06 |
| 1891337770 | Matthew Steven Baker | Physician Assistant | 3300 Main St, Springfield, MA 01107-1112 | 2019-10-12 |
| 1174091474 | Tracie Lacasse | Nurse Practitioner | 3300 Main St, Springfield, MA 01107-1112 | 2018-11-05 |
| 1366921983 | Elizabeth Marie Jarry | Nurse Practitioner | 3300 Main St, Springfield, MA 01107-1112 | 2018-08-14 |
| 1871009886 | Sage Kenyon Dow | Nurse Practitioner | 3300 Main St, Springfield, MA 01107-1112 | 2017-12-28 |
| 1124566948 | Elizabeth Howell Mitchell Burns | Clinical Neuropsychologist | 3300 Main St, Springfield, MA 01107-1112 | 2017-02-01 |
| 1245780774 | Lauren Elyse Miller | Student in an Organized Health Care Education/Training Program | 3300 Main St, Suite 4a, Springfield, MA 01199-1002 | 2016-10-07 |
| 1326597253 | Emily Annette Jackson | Advanced Practice Midwife | 3300 Main St, Ste 4d, Springfield, MA 01107-1112 | 2016-10-04 |
| 1588017024 | Janet Namono | Social Worker | 3300 Main St, 4th Floor, Springfield, MA 01199-1002 | 2016-07-20 |
| 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 | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1770093122 | Genoa Healthcare, LLC | Pharmacy | 417 Liberty St Ste 1b, Springfield, MA 01104-3739 | 2017-10-11 |
| 1316483266 | Springfield Clinic, LLP | Pharmacy | 900 N 1st St Rm 4066, Springfield, IL 62702-3749 | 2017-01-17 |
| 1194277681 | Grove Professional Pharmacy, Inc | Pharmacy | 1636 S Glenstone Ave Ste 108, Springfield, MO 65804-1512 | 2016-10-31 |
| 1962852012 | Main Sail Enterprises South LLC | Pharmacy | 222 E Primrose St Ste B, Springfield, MO 65807-5233 | 2016-06-20 |
| 1588042816 | Main Sail Enterprises-downtown LLC | Pharmacy | 655 S Campbell Ave, Springfield, MO 65806-2901 | 2015-05-06 |
| 1972901189 | Fred's Stores of Tennessee Inc | Pharmacy | 1117 Lincoln Park Rd, Springfield, KY 40069 | 2014-12-22 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1932529716 | Walgreen Co | Pharmacy | 440 E Tampa St Ste 100, Springfield, MO 65806-1131 | 2014-04-21 |
| 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.