Individual provider Active NPI

Bryan Michael Kasperowski, DMD

  • General Practice Dentistry
  • Westfield, MA
National Provider Identifier
1720003072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20695 Issued in MA
Practice address
79 Broad St
Westfield, MA 01085-2925
Phone
(413) 562-5494
Fax
(413) 568-5597
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20695 MA Primary

Addresses

Primary practice location

79 Broad St
Westfield, MA 01085-2925

Mailing address

79 Broad St
Westfield, MA 01085-2925
Phone (413) 562-5494

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150321000402 MA Order and Referring Only - DentistPractitioner - Dentist 6002133519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20695MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan M. Kasperowski DMD LLC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720003072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 BROAD ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010852925",
            "telephone_number": "413-562-5494",
            "fax_number": "413-568-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BROAD ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010852925",
            "telephone_number": "413-562-5494",
            "fax_number": "413-568-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASPEROWSKI",
        "first_name": "BRYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

Verify at the official NPI Registry.