Individual provider Active NPI

Jamison A Bradshaw, DO

  • Psychiatry Physician
  • Springfield, MA
National Provider Identifier
1588026959
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
281926 Issued in MA
Practice address
Baystate Medical Ctr
759 Chestnut Street
Springfield, MA 01199
Phone
(413) 794-0000
NPI assigned
Mar 24, 2016
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 281926 MA Primary

Addresses

Primary practice location

Baystate Medical Ctr
759 Chestnut Street
Springfield, MA 01199

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-0001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200227001044 MA Practitioner - Psychiatry 7214222173 Reassigns benefits to 1 organization
I20220804003090 CA Practitioner - Psychiatry 7214222173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Rowan University School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lyon-Martin Community Health ServicesGroup PAC ID 6103203930, 19 clinicians
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

1735 Mission St
San Francisco, CA 94103-2417
Phone (415) 565-7667

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 794-8121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19279CAMDChiropractor
281926MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Psychiatry CurrentSince Feb 11, 2020 Accepting new patients
Lyon-Martin Community Health Services CurrentSince Jun 20, 2022 Accepting new patients
Baystate Medical Center Inc Past Accepting new patients
Baystate Medical Center Inc Past Accepting new patients
Baystate Medical Center Inc Past Accepting new patients

Locations

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

Interoperability endpoints

  • Direct secure messaging: jbradshaw524403@direct.ochin.org

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.

Hospital & facility affiliations 2

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1588026959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011990001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAYSTATE MEDICAL CTR",
            "address_2": "759 CHESTNUT STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01199",
            "telephone_number": "413-794-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "JAMISON",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "281926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.