Individual provider Active NPI

Biji Manoj Vengalil, NP

  • Family Nurse Practitioner
  • Pittsfield, MA
National Provider Identifier
1104202118
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN245714 Issued in MA
Practice address
165 Tor CT
Pittsfield, MA 01201-3001
Phone
(413) 447-2701
Fax
(413) 447-2101
NPI assigned
Aug 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN245714 MA Primary

Addresses

Primary practice location

165 Tor CT
Pittsfield, MA 01201-3001

Mailing address

777 North St Ste 307
Pittsfield, MA 01201-4123
Phone (413) 496-6838

Other practice location 1

777 North St Ste 307
Pittsfield, MA 01201-4123
Phone (413) 496-6838

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201001744 MA Practitioner - Nurse Practitioner 0749584480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

55 Pittsfield Rd BLDG
12D Lenox Family Health Center of BMC
Lenox, MA 01240-2185
Phone (413) 344-1700

Hospital & facility affiliations

  • Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Dec 1, 2015 Accepting new patients
Berkshire Faculty Services Inc CurrentSince Dec 1, 2015 Accepting new patients
Berkshire Medical Center Inc. PastSince Mar 6, 2022 Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

55 Pittsfield Rd
Ste 12D
Lenox, MA 01240
Phone (413) 344-1700

777 North St
Ste 307
Pittsfield, MA 01201
Phone (413) 496-6838

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

165 Tor Ct
Pittsfield, MA 01201
Phone (413) 447-2862

Interoperability endpoints

  • Direct secure messaging: bijivengalil@bfs.medalliesdirect.net

Organizations & group practices 3

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 1

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": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1104202118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 NORTH ST STE 307",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014123",
            "telephone_number": "413-496-6838",
            "fax_number": "413-496-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 TOR CT",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012013001",
            "telephone_number": "413-447-2701",
            "fax_number": "413-447-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 North St Ste 307",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "MA",
            "postal_code": "012014123",
            "country_code": "US",
            "telephone_number": "413-496-6838",
            "fax_number": "413-496-6869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENGALIL",
        "first_name": "BIJI",
        "middle_name": "MANOJ",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-03",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN245714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.