Individual provider Active NPI

Gregory A Bazylewicz, MD

  • Family Medicine Physician
  • Manchester, MA
National Provider Identifier
1245315563
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45749 Issued in MA
Practice address
195 School Street
Manchester, MA 01944
Phone
(978) 526-4311
Fax
(978) 525-2342
NPI assigned
Oct 26, 2006
Last updated
Mar 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45749 MA Primary

Addresses

Primary practice location

195 School Street
Manchester, MA 01944

Mailing address

195 School Street
Manchester, MA 01944
Phone (978) 526-4311

Other identifiers 3

IdentifierTypeStateIssuer
BAD16009OtherMABLUE CROSS BLUE SHIELD
045749OtherMATUFTS
0126632MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45749MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care Inc Past Accepting new patients
Family Medicine Associates LLC Family Medicine PastSince Sep 1, 2005 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1245315563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 SCHOOL STREET",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "01944",
            "telephone_number": "978-526-4311",
            "fax_number": "978-525-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 SCHOOL STREET",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "01944",
            "telephone_number": "978-526-4311",
            "fax_number": "978-525-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZYLEWICZ",
        "first_name": "GREGORY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "45749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "BAD16009",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "045749",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0126632",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.