Individual provider Active NPI

Glenda Jeannette Bowen, M.D.

  • Pulmonary Disease Physician
  • Pittsfield, MA
National Provider Identifier
1407290398
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
287531 Issued in MA
Practice address
725 North St
Pittsfield, MA 01201-4124
Phone
(413) 447-2695
Fax
(413) 447-3111
NPI assigned
Apr 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 054662 CT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 287531 MA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 054662 CT
Pulmonary Disease Physician 207RP1001X 054662 CT
Sleep Medicine (Internal Medicine) Physician 207RS0012X 287531 MA
Hospitalist Physician 208M00000X 054662 CT
Pulmonary Disease Physician 207RP1001X 287531 MA Primary

Addresses

Primary practice location

725 North St
Pittsfield, MA 01201-4124

Mailing address

725 North St
Pittsfield, MA 01201-4124
Phone (413) 447-2695

Other names 1

  • Dr. Glenda Jeannette Euceda Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210901001709 MA Practitioner - Pulmonary DiseasePractitioner - Sleep MedicinePractitioner - Critical Care (Intensivists) 4486951555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Sleep Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berkshire Faculty Services IncGroup PAC ID 8224068424, 276 clinicians

Practice addresses (Care Compare)

725 N St
Pittsfield, MA 01201-4109
Phone (413) 447-2695

Hospital & facility affiliations

  • Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046
  • Fairview Hospital Hospital, Great Barrington, MA, CCN 221302
  • North Adams Regional Hospital Corporation Hospital, North Adams, MA, CCN 221304

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054662CTMDPulmonary Disease Physician
287531MAMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Aug 5, 2021 Accepting new patients
Berkshire Faculty Services Inc CurrentSince Aug 5, 2021 Accepting new patients
Hillcrest Family Health Center Internal Medicine Past Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

165 Tor Ct
Pittsfield, MA 01201
Phone (413) 447-2862

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1407290398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014124",
            "telephone_number": "413-447-2695",
            "fax_number": "413-447-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014124",
            "telephone_number": "413-447-2695",
            "fax_number": "413-447-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "GLENDA",
        "middle_name": "JEANNETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "054662",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MA",
            "license": "287531",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CT",
            "license": "054662",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "054662",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MA",
            "license": "287531",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "054662",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "287531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "EUCEDA",
            "middle_name": "JEANNETTE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.