Individual provider Active NPI

Gina M Quinlivan

  • Advanced Practice Midwife
  • East Longmeadow, MA
National Provider Identifier
1053468629
Registry record updated Aug 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
195514 Issued in MA
Practice address
382 N Main St Ste 205
East Longmeadow, MA 01028
Phone
(134) 794-8484
Fax
(413) 794-5910
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 195514 MA Primary

Addresses

Primary practice location

382 N Main St Ste 205
East Longmeadow, MA 01028

Mailing address

382 N Main St
Ste 205
E Longmeadow, MA 01028-1830
Phone (508) 882-3141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180828000371 MA Practitioner - Certified Nurse Midwife (CNM) 7911256755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate OB/GYN Group IncGroup PAC ID 1153392659, 20 clinicians

Practice addresses (Care Compare)

21 Dwight Rd
Suite 201
Longmeadow, MA 01106-1765
Phone (413) 794-8484

470 Granby Rd
South Hadley, MA 01075-3222
Phone (413) 533-7200

Hospital & facility affiliations

  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
195514MAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate OB/GYN Group Inc CurrentSince Aug 22, 2018 Accepting new patients

Locations

382 N Main St
Ste 205
East Longmeadow, MA 01028
Phone (413) 525-5244

470 Granby Rd
South Hadley, MA 01075
Phone (413) 533-3926

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12089/brand/1/csg/1/fhir/r4
  • Direct secure messaging: gina.quinlivan.1@12089.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1053468629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 N MAIN ST",
            "address_2": "STE 205",
            "city": "E LONGMEADOW",
            "state": "MA",
            "postal_code": "010281830",
            "telephone_number": "508-882-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 N MAIN ST STE 205",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "01028",
            "telephone_number": "134-794-8484",
            "fax_number": "413-794-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINLIVAN",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "195514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Longmeadow, MA

Sources for this page

Verify at the official NPI Registry.