Individual provider Active NPI

Kentston Bauman, PA-C

  • Student in an Organized Health Care Education/Training Program
  • South Hadley, MA
National Provider Identifier
1659006450
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
103 Woodbridge St
South Hadley, MA 01075-1128
Phone
(734) 883-3203
NPI assigned
Jul 18, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

103 Woodbridge St
South Hadley, MA 01075-1128

Mailing address

103 Woodbridge St
South Hadley, MA 01075-1128
Phone (734) 883-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20221011001761 MA Practitioner - Physician Assistant 9638545932 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holyoke Medical Center IncGroup PAC ID 2163419383, 202 clinicians

Practice addresses (Care Compare)

575 Beech St
Holyoke, MA 01040-2223

Hospital & facility affiliations

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
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Holyoke Medical Center, Inc. CurrentSince Nov 15, 2022 Accepting new patients

Locations

262 New Ludlow Rd
Chicopee, MA 01020
Phone (413) 535-4714

10 Hospital Dr
Ste 306
Holyoke, MA 01040
Phone (413) 539-6830

575 Beech St
Ste 402
Holyoke, MA 01040
Phone (413) 534-2820

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

Interoperability endpoints

  • Direct secure messaging: kentston.bauman@direct.hmcs.masshiway.net

Organizations & group practices 2

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

Hospital & facility affiliations 1

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": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1659006450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WOODBRIDGE ST",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010751128",
            "telephone_number": "734-883-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WOODBRIDGE ST",
            "city": "SOUTH HADLEY",
            "state": "MA",
            "postal_code": "010751128",
            "telephone_number": "734-883-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "KENTSTON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hadley, MA

Sources for this page

Verify at the official NPI Registry.