Individual provider Active NPI

David J. Barth, PA

  • Physician Assistant
  • Holyoke, MA
National Provider Identifier
1538281670
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA5787 Issued in MA
Practice address
1233 Main St
Holyoke, MA 01040-5381
Phone
(413) 539-2845
Fax
(413) 539-2992
NPI assigned
Apr 6, 2007
Last updated
Dec 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001639 CT
Physician Assistant 363A00000X PA5787 MA Primary

Addresses

Primary practice location

1233 Main St
Holyoke, MA 01040-5381

Mailing address

52 Beach Rd
Ste 104
Fairfield, CT 06824-6017
Phone (203) 254-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070505000031 CT Practitioner - Physician Assistant 7810093044 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 1, 2025 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2025 Accepting new patients
Connecticut Psychiatric & Wellness Center Past Accepting new patients

Locations

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1538281670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BEACH RD",
            "address_2": "STE 104",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246017",
            "telephone_number": "203-254-2000",
            "fax_number": "203-255-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 MAIN ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405381",
            "telephone_number": "413-539-2845",
            "fax_number": "413-539-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTH",
        "first_name": "DAVID",
        "middle_name": "J.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001639",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.