NPIMap

Individual provider Active NPI

Glen P Bombardier, MD

  • Internal Medicine Physician
  • Holyoke, MA
National Provider Identifier
1487741757
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
45861 Issued in MA
Practice address
10 Hospital Drive
Suite 308
Holyoke, MA 01040-6603
Phone
(413) 533-7139
Fax
(413) 533-2901
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 45861 MA Primary

Addresses

Primary practice location

10 Hospital Drive
Suite 308
Holyoke, MA 01040-6603

Mailing address

10 Hospital Drive
Suite 308
Holyoke, MA 01040-6603
Phone (413) 533-7139

Other identifiers 1

IdentifierTypeStateIssuer
0133345MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050519000222 MA Practitioner - Internal Medicine 5991746000 Practice locations: Holyoke, MA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albany Medical College of Union University, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10 Hospital Dr
Holyoke, MA 01040-6603
Phone (413) 533-7139

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Agawam, MA, CCN 227288
  • Elara Caring Home health agency, Braintree, MA, CCN 227475
  • Caretenders Home health agency, Holyoke, MA, CCN 227584
  • Holyoke Visiting Nurse Assoc Home health agency, Holyoke, MA, CCN 227015
  • Baystate Home Health Home health agency, W Springfield, MA, CCN 227011
  • Holyoke Medical Center Hospital, Holyoke, MA, CCN 220024
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015
  • Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45861MAMDInternal Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BECDBA/Endpoint/BECDBA

Hospital & facility affiliations 11

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1487741757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DRIVE",
            "address_2": "SUITE 308",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010406603",
            "telephone_number": "413-533-7139",
            "fax_number": "413-533-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOSPITAL DRIVE",
            "address_2": "SUITE 308",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010406603",
            "telephone_number": "413-533-7139",
            "fax_number": "413-533-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBARDIER",
        "first_name": "GLEN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "45861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0133345",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.