Organization
BAYSTATE MEDICAL PRACTICES, INC.
Active
Parent organization
BAYSTATE MEDICAL PRACTICES, INC.
Other names
BMP, Dept of Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYSTATE MEDICAL PRACTICES, INC.
Authorized official
RANDALL L VAILL JR. (MANAGER PROVIDER ENROLLMENT)
(413) 794-7976
Entity
Organization
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-1001
(413) 794-5700
(413) 794-1629
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
(413) 794-5700
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
01/02/2007
Last updated
02/26/2014
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