NPIMap

Organization Active NPI

Central Berkshire Gastroenterology, PC

  • Specialist
  • Pittsfield, MA
National Provider Identifier
1619957974
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CENTRAL BERKSHIRE GASTROENTEROLOGY, PC
Practice address
777 North St
Suite 203
Pittsfield, MA 01201-4147
Phone
(413) 499-8590
Fax
(413) 499-6410
NPI assigned
Jan 20, 2006
Last updated
Apr 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Authorized official

Name
Dr. Larry J Pellish, M.D.NPI 1821069832
Title
President
Phone
(413) 499-8590

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
Specialist 174400000X Primary

Addresses

Primary practice location

777 North St
Suite 203
Pittsfield, MA 01201-4147

Mailing address

777 North St
Suite 203
Pittsfield, MA 01201-4147
Phone (413) 499-8590

Other identifiers 5

IdentifierTypeStateIssuer
02102165MedicaidNY
7787OtherNYCDPHP
9701435MedicaidMA
687342OtherMATUFTS HEALTHPLAN
M17617OtherMABCBSMA

National Provider Directory

National Provider Directory

Locations

777 North St
Ste 203
Pittsfield, MA 01201
Phone (413) 447-2858

Practitioners & affiliated clinicians

Practitioners 6

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": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1619957974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 NORTH ST",
            "address_2": "SUITE 203",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014147",
            "telephone_number": "413-499-8590",
            "fax_number": "413-499-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 NORTH ST",
            "address_2": "SUITE 203",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014147",
            "telephone_number": "413-499-8590",
            "fax_number": "413-499-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL BERKSHIRE GASTROENTEROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "PELLISH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-499-8590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02102165",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "7787",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9701435",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTHPLAN",
            "identifier": "687342",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "M17617",
            "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 Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.