Jean Altis

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

120 Maple St
Springfield, MA 01103-2203

Phone

(413) 846-0445

NPI assigned

Aug 9, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Community Caring Clinic LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roxbury, MA
  • NPI 1184112377
  Medicare reassignment NPD
• Gandara Mental Health Center

  • Case Management Agency
  • West Springfield, MA
  • NPI 1447556246
  NPD (past)

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1295014272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MAPLE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011032203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MAPLE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011032203",
            "telephone_number": "413-846-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTIS",
        "first_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1307576",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303295",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "M18463",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hala Alsalhi, DO
• Laila Rajaan M Alshaiye
• Janivette Alsina, MD, PHD
• Simone Bernette Alter-Muri, ED.D, ATR-BC, LMHC
• Jeanelle M Altiery
• Larisa Altman, NP
• Ana Alvarado
• Bernice Alvarado
• Caroll Alvarado
• Yisel Jhoandra Alvarado

• Counselor in Springfield, MA
• Providers in Springfield, MA by specialty
• Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.