NPIMap

Organization Active NPI

Western Massachusetts Pathology Services, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Pittsfield, MA
National Provider Identifier
1295812360
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
45390 Issued in MA
Legal business name
WESTERN MASSACHUSETTS PATHOLOGY SERVICES, PC
Practice address
725 North St
Pathology Department
Pittsfield, MA 01201-4109
Phone
(413) 447-2000
Fax
(413) 447-2097
NPI assigned
Nov 1, 2006
Last updated
Jul 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Jessica Diane Krochmal, MDNPI 1568686400
Title
President
Phone
(413) 447-2569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 45390 MA Primary

Addresses

Primary practice location

725 North St
Pathology Department
Pittsfield, MA 01201-4109

Mailing address

PO Box 781
Lewiston, ME 04243-0781
Phone (413) 447-2000

Other identifiers 8

IdentifierTypeStateIssuer
9775102MedicaidMA
M16092OtherMABC/BS
102749600OtherUS DEPT OF LABOR
003124683MedicaidCT
751038OtherMATUFTS HEALTH PLAN
1005020MedicaidVT
000000024512OtherMABMC HEALTH NET
0011307OtherMANEIGHBORHOOD HEALTH PLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050830000661 MA Part B Supplier - Clinic/Group Practice 3072544907 Receives reassigned benefits from 5 practitioners
Practice locations: Great Barrington, MA; Pittsfield, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1295812360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042430781",
            "telephone_number": "413-447-2000",
            "fax_number": "413-447-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "address_2": "PATHOLOGY DEPARTMENT",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014109",
            "telephone_number": "413-447-2000",
            "fax_number": "413-447-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MASSACHUSETTS PATHOLOGY SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "KROCHMAL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-447-2569",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "45390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9775102",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "M16092",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "102749600",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003124683",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "751038",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005020",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTH NET",
            "identifier": "000000024512",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0011307",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.