Active NPI
Fred E Mensch, MD
- Dermatology Physician
- Pittsfield, MA
National Provider Identifier
1740364298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 47652
- Practice address
- 426 South St
Pittsfield, MA 01201-8228 - Phone
- (413) 496-9272
- Fax
- (413) 442-6990
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 47652 | MA | Primary |
Addresses
Primary practice location
426 South St
Pittsfield, MA 01201-8228
Mailing address
426 South St
Pittsfield, MA 01201-8228
Phone (413) 496-9272
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0151785 | Medicaid | MA | |
| I22276 | Other | MA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47652 | MA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1740364298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "426 SOUTH ST",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012018228",
"telephone_number": "413-496-9272",
"fax_number": "413-442-6990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "426 SOUTH ST",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012018228",
"telephone_number": "413-496-9272",
"fax_number": "413-442-6990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENSCH",
"first_name": "FRED",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MA",
"license": "47652",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0151785",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "I22276",
"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 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.