Organization Active NPI

Baystate Orthopedics, Inc

  • Specialist
  • Springfield, MA
National Provider Identifier
1629280490
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BAYSTATE ORTHOPEDICS, INC
Practice address
3455 Main St Ste 2
Springfield, MA 01107-1147
Phone
(413) 746-9142
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Alan H Bullock, M.D.
Title
President
Phone
(413) 746-9142

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3455 Main St Ste 2
Springfield, MA 01107-1147

Mailing address

3455 Main St Ste 2
Springfield, MA 01107-1147
Phone (413) 746-9142

Other identifiers 3

IdentifierTypeStateIssuer
000000006256OtherMABMC HEALTHNET
2002985OtherMABLUE SHIELD
455321OtherMACONNECTICARE

National Provider Directory

National Provider Directory

Locations

300 Birnie Ave
Ste 305
Springfield, MA 01107
Phone (413) 746-9142

3455 Main St
Ste 2
Springfield, MA 01107
Phone (413) 746-9142

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629280490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 MAIN ST STE 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071147",
            "telephone_number": "413-746-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 MAIN ST STE 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071147",
            "telephone_number": "413-746-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSTATE ORTHOPEDICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-746-9142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000006256",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "2002985",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "455321",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.