Organization Active NPI

Pittsfield Medical Associates, Inc.

  • Internal Medicine Physician
  • Pittsfield, MA
National Provider Identifier
1083766588
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PITTSFIELD MEDICAL ASSOCIATES, INC.
Practice address
510 North St
Pittsfield, MA 01201-4111
Phone
(413) 499-2921
Fax
(413) 499-2762
NPI assigned
Jan 17, 2007
Last updated
Jul 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Mrs. Jean A Connolly
Title
Bookkeeper
Phone
(413) 499-2921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

510 North St
Pittsfield, MA 01201-4111

Mailing address

510 North St
Pittsfield, MA 01201-4111
Phone (413) 499-2921

Other identifiers 1

IdentifierTypeStateIssuer
9712992MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100203000510 MA Part B Supplier - Clinic/Group Practice 8729121439 Receives reassigned benefits from 2 practitioners
Practice locations: Pittsfield, MA

National Provider Directory

National Provider Directory

Locations

188 East St
Ste 102
Pittsfield, MA 01201
Phone (413) 442-2100

510 North St
Ste 7
Pittsfield, MA 01201
Phone (413) 447-2300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18602/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1083766588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014111",
            "telephone_number": "413-499-2921",
            "fax_number": "413-499-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014111",
            "telephone_number": "413-499-2921",
            "fax_number": "413-499-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITTSFIELD MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "413-499-2921",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9712992",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.