Shasta A Kielbasa, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

250422 Issued in MA

Practice address

30 Locust St
Northampton, MA 01060-2052

Phone

(413) 582-2792

Fax

(413) 582-4675

NPI assigned

Aug 13, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shasta A Kielbasa Other name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

University of Massachusetts Medical School, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mass General Brigham Medical Group Western Massachusetts IncGroup PAC ID 2567359839, 291 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kielbasa.shasta.cdh@direct.partners.masshiway.net

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.

• Mass General Brigham Medical Group Western Massachusetts Inc

  • Family Medicine Physician
  • Northampton, MA
  • NPI 1295787919

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Cooley Dickinson Hospital Inc

  • General Acute Care Hospital
  • Northampton, MA
  • NPI 1477596310
  NPD (past)

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

• Cooley Dickinson Hospital Inc

  • General Acute Care Hospital
  • Northampton, MA
  • NPI 1477596310
  Care Compare affiliation
• Cooley Dickinson Hospital Inc

  • Psychiatric Hospital Unit
  • Northampton, MA
  • NPI 1871512814
  Care Compare affiliation

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1245486901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LOCUST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602052",
            "telephone_number": "413-582-2792",
            "fax_number": "413-582-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LOCUST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602052",
            "telephone_number": "413-582-2792",
            "fax_number": "413-582-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIELBASA",
        "first_name": "SHASTA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "250422",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "250422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHASTA",
            "last_name": "KIELBASA",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephanie Kerrigan
• VI Vien Khoo, RDN
• Ursula Helene Kiczkowski, LMSW
• Leanne E Kidd, MSPT
• Kidney Care and Transplant Services of New England, PC
• Gail Kielson, LICSW
• Margaret Laura Kierstein, ED.D.
• David Kieval, PSY.D., BCBA
• Sarah Jane Killion, MSW, LICSW
• Alex J Kim, MSW, LICSW

• Internal Medicine Physician in Northampton, MA
• Providers in Northampton, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.