Individual provider Active NPI

Jesse T Casaubon, D.O.

  • Surgical Oncology Physician
  • Springfield, MA
National Provider Identifier
1861834608
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
281601 Issued in MA
Practice address
100 Wason Ave Ste 340
Springfield, MA 01107-1179
Phone
(413) 794-5265
Fax
(413) 794-1794
NPI assigned
Jul 22, 2013
Last updated
Oct 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 281601 MA Primary

Addresses

Primary practice location

100 Wason Ave Ste 340
Springfield, MA 01107-1179

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-3909

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111000122 MA Practitioner - Surgical Oncology 4981036134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

100 Wason Ave
Springfield, MA 01107-1381
Phone (413) 788-6139

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
281601MAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc CurrentSince Oct 25, 2019 Accepting new patients

Locations

100 Wason Ave
Springfield, MA 01107
Phone (413) 794-2442

100 Wason Ave
Ste 340
Springfield, MA 01107
Phone (413) 794-5265

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

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

Hospital & facility affiliations 2

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1861834608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WASON AVE STE 340",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071179",
            "telephone_number": "413-794-5265",
            "fax_number": "413-794-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASAUBON",
        "first_name": "JESSE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "MA",
            "license": "281601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.