Active NPI
Allcroft Facial Plastic Surgery, PC
- Otolaryngology/Facial Plastic Surgery Physician
- Northampton, MA
National Provider Identifier
1003930728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology/Facial Plastic Surgery Physician
- Legal business name
- ALLCROFT FACIAL PLASTIC SURGERY, PC
- Practice address
- 163 Conz St
Northampton, MA 01060-3848 - Phone
- (413) 586-3200
- Fax
- (413) 587-0970
- NPI assigned
- Mar 19, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandi C Chagnon
- Title
- Credentials Specialist
- Phone
- (413) 582-2656
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | Primary |
Addresses
Primary practice location
163 Conz St
Northampton, MA 01060-3848
Mailing address
163 Conz St
Northampton, MA 01060-3848
Phone (413) 586-3200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040824001093 | MA | Part B Supplier - Clinic/Group Practice | 2163496274 |
Receives reassigned benefits from 1 practitioner Practice locations: Northampton, MA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0932955 | Allcroft Facial Plastic Surgery PC | Certificate of waiver | Dec 13, 2027 |
National Provider Directory
National Provider DirectoryLocations
163 Conz St
Northampton, MA 01060
Phone (413) 586-3200
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- South Deerfield, MA
- NPI 1598734188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213315200000",
"number": "1003930728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 CONZ ST",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010603848",
"telephone_number": "413-586-3200",
"fax_number": "413-587-0970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 CONZ ST",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010603848",
"telephone_number": "413-586-3200",
"fax_number": "413-587-0970"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLCROFT FACIAL PLASTIC SURGERY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-19",
"last_updated": "2008-06-13",
"status": "A",
"authorized_official_last_name": "CHAGNON",
"authorized_official_first_name": "SANDI",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "CREDENTIALS SPECIALIST",
"authorized_official_telephone_number": "413-582-2656"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Northampton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.