Active NPI
Mountain Medicine PC
- Internal Medicine Physician
- Pittsfield, MA
National Provider Identifier
1679531354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- MOUNTAIN MEDICINE PC
- Practice address
- 1450 East St Ste 6N
Pittsfield, MA 01201-5319 - Phone
- (413) 442-4700
- Fax
- (413) 442-4711
- NPI assigned
- May 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Christine M Dagostino
- Title
- Treasurer
- Phone
- (413) 442-4700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
1450 East St Ste 6N
Pittsfield, MA 01201-5319
Mailing address
1565 Hancock Rd
Williamstown, MA 01267
Phone (413) 442-4700
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3183386 | Medicaid | MA | |
| 8906530002 | Other | CIGNA | |
| MD0341139AR | Other | MA CONTROL # | |
| 156843 | Other | TUFTS | |
| 32023 | Other | HNE | |
| J19130 | Other | MA BLUE SHIELD | |
| 3183386 | Other | MASS HEALTH | |
| 111654 | Other | MVP | |
| 11S654 | Other | MVP/PIN # | |
| 16095 | Other | NHP | |
| 3516813 | Other | AETNA | |
| 000000020879 | Other | BERKSHIRE HEALTH NET | |
| 000000028890 | Other | BMC HEALTH NET | |
| 1006517 | Other | VT MEDICAID | |
| 156843 | Other | MA LICENSE | |
| 3183386 | Other | MA MEDICAID |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1191974400000",
"number": "1679531354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1565 HANCOCK RD",
"city": "WILLIAMSTOWN",
"state": "MA",
"postal_code": "01267",
"telephone_number": "413-442-4700",
"fax_number": "413-442-4711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 EAST ST STE 6N",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012015319",
"telephone_number": "413-442-4700",
"fax_number": "413-442-4711"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOUNTAIN MEDICINE PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-03",
"last_updated": "2007-10-10",
"status": "A",
"authorized_official_last_name": "DAGOSTINO",
"authorized_official_first_name": "CHRISTINE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "TREASURER",
"authorized_official_telephone_number": "413-442-4700",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3183386",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "8906530002",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA CONTROL #",
"identifier": "MD0341139AR",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "156843",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HNE",
"identifier": "32023",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA BLUE SHIELD",
"identifier": "J19130",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS HEALTH",
"identifier": "3183386",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "111654",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP/PIN #",
"identifier": "11S654",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "16095",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3516813",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BERKSHIRE HEALTH NET",
"identifier": "000000020879",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC HEALTH NET",
"identifier": "000000028890",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VT MEDICAID",
"identifier": "1006517",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA LICENSE",
"identifier": "156843",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA MEDICAID",
"identifier": "3183386",
"state": null
}
],
"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 Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.