# BAYSTATE MEDICAL PRACTICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BAYSTATE MEDICAL PRACTICES, INC.
- **Other names:** BMP, Dept of OBGYN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336205582
- **Legal business name:** BAYSTATE MEDICAL PRACTICES, INC.
- **Authorized official:** RANDALL L VAILL JR. (MANAGER PROVIDER ENROLLMENT)
- **Authorized official phone:** (413) 794-7976

## Contact information

- **Practice address:** 759 CHESTNUT ST, SPRINGFIELD, MA 01199-1001
- **Practice address phone:** (413) 794-5700
- **Practice address fax:** (413) 794-1629
- **Mailing address:** 280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
- **Mailing address phone:** (413) 794-5700
- **Mailing address fax:** (413) 794-1629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VE0102X | Reproductive Endocrinology Physician | — | NULL | — |
| 207VE0102X | Reproductive Endocrinology Physician | — | — | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | — |
| 207VX0201X | Gynecologic Oncology Physician | — | NULL | — |
| 207VX0201X | Gynecologic Oncology Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 02/26/2014