Organization Active NPI

Allcroft Facial Plastic Surgery, PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Northampton, MA
National Provider Identifier
1003930728
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
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

Updated by the provider on Jun 13, 2008

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)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0932955Allcroft Facial Plastic Surgery PC163 Conz Street, Northampton, MA 01060Certificate of waiverDec 13, 2027

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.