Individual provider Active NPI

Kim Gaitskill, MD

  • Child & Adolescent Psychiatry Physician
  • Amherst, MA
National Provider Identifier
1760465520
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
76779 Issued in MA
Practice address
48 N Pleasant St
Suite 206
Amherst, MA 01002-1738
Phone
(978) 852-7671
Fax
(413) 835-0223
NPI assigned
Nov 26, 2005
Last updated
Nov 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 76779 MA Primary

Addresses

Primary practice location

48 N Pleasant St
Suite 206
Amherst, MA 01002-1738

Mailing address

48 N Pleasant St
Suite 206
Amherst, MA 01002-1738
Phone (978) 852-7671

Other identifiers 1

IdentifierTypeStateIssuer
3102157MedicaidMA

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

LicenseStateTypeSpecialty
76779MAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Child & Adolescent Psychiatry Past Accepting new patients
Servicenet Inc PastSince Feb 4, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1760465520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 N PLEASANT ST",
            "address_2": "SUITE 206",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010021738",
            "telephone_number": "978-852-7671",
            "fax_number": "413-835-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 N PLEASANT ST",
            "address_2": "SUITE 206",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010021738",
            "telephone_number": "978-852-7671",
            "fax_number": "413-835-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAITSKILL",
        "first_name": "KIM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-26",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "76779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3102157",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.