NPIMap

Organization Active NPI

Baystate Noble Hospital Corporation

Doing business as Baystate Noble Hospital Bronson Rehabilitation Unit

  • Rehabilitation Hospital Unit
  • Westfield, MA
National Provider Identifier
1245272012
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
2076 Issued in MA
Legal business name
BAYSTATE NOBLE HOSPITAL CORPORATION
Doing business as
Baystate Noble Hospital Bronson Rehabilitation Unit
Practice address
115 W Silver St
Westfield, MA 01085-3628
Phone
(413) 568-2811
Fax
(413) 562-5855
NPI assigned
Jun 13, 2006
Last updated
May 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Authorized official

Name
David Witherell
Title
Senior Director, Payment Systems
Phone
(413) 794-7930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 2076 MA Primary

Addresses

Primary practice location

115 W Silver St
Westfield, MA 01085-3628

Mailing address

115 W Silver St
Westfield, MA 01085-3628
Phone (413) 568-2811

Other names 1

  • Baystate Noble Hospital Bronson Rehabilitation Unit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100820001056 MA Part A Provider - Hospital 2264405638 Practice locations: Westfield, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245272012. Details of each certification follow.

Hospital certification: CCN 22T065

Legal name
BAYSTATE NOBLE HOSPITAL CORPORATION
Doing business as
BAYSTATE NOBLE HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
115 W Silver St
Westfield, MA 10853678
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Noble HospitalCCN 22T065 · All quality measures
Ownership
Non-profit
Certified
Oct 1, 1990

National Provider Directory

National Provider Directory
Tax ID family
The Trustees of Noble H2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark a O'Connell Individual Corporate Director Jan 1, 2023
Nicolas Jabbour Individual Corporate Director Jan 1, 2024
Julie Quink Individual Corporate Director Jan 1, 2024
Ruth H Constantine Individual Corporate Director Feb 8, 2022
Sara a Rourke Individual Corporate Director Jan 1, 2022
Paul Gosselin Individual Corporate Director Jun 19, 2026
Nancy Remillard Individual Corporate OfficerAssistant Clerk Nov 13, 2018
Peter Banko Individual Corporate OfficerPresident & Ceo Baystate Health Jun 3, 2024
Corporate DirectorPresident & Ceo Baystate Health Jun 3, 2024
Linda Thompson Individual Corporate Director Jan 1, 2023
Claudia R Coplein Individual Corporate Director Jan 1, 2017
Denise R. Jordan Individual Corporate Director Jan 1, 2020
Baystate Health, Inc Organization, Springfield, MA Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2015 100%
Madeline Landrau Individual Corporate Director Jan 1, 2024
Akinyele K Lovelace Individual Corporate OfficerVice Chair Jul 3, 2025
Corporate Director Jan 1, 2020
Paul C. Picknelly Individual Corporate Director Jan 1, 2020
Harriet a Deverry Individual Corporate Officer Jan 1, 2023
Corporate Director Jul 1, 2015
Colleen W Holmes Individual Corporate OfficerChair Jan 1, 2023
Corporate Director Jan 1, 2017
Richard D Bossie Individual Corporate Director Jan 1, 2022
Antonio E Dos-Santos Individual Corporate Director Jan 1, 2023
Baystate Administrative Services, Inc. Organization, Springfield, MA Non-profit Operational/Managerial Control Jul 1, 2015
Vittal R Setru Individual Corporate Director Jul 3, 2025
Maria P Goncalves Individual Corporate Director Jan 1, 2018
Irene Rodriguez-Martin Individual Corporate Director Jan 1, 2018
Brandon E Okezie Individual Corporate Officer Jul 3, 2025
W-2 Managing Employee Jul 3, 2025
William R Webber Individual Corporate Director Jan 1, 2017
Laurie Martin Individual Corporate OfficerTreasurer Jul 31, 2025

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1245272012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W SILVER ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010853628",
            "telephone_number": "413-568-2811",
            "fax_number": "413-562-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W SILVER ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010853628",
            "telephone_number": "413-568-2811",
            "fax_number": "413-562-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSTATE NOBLE HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "WITHERELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, PAYMENT SYSTEMS",
        "authorized_official_telephone_number": "413-794-7930"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "MA",
            "license": "2076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Baystate Noble Hospital Bronson Rehabilitation Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baystate Noble Hospital Bronson Rehabilitation Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westfield, MA

Sources for this page

Verify at the official NPI Registry.