Individual provider Active NPI

Beverly A Faille

  • Nurse Practitioner
  • Springfield, MA
National Provider Identifier
1952564981
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
255880 Issued in MA
Practice address
300 Birnie Ave
Springfield, MA 01107-1107
Phone
(413) 785-4666
Fax
(413) 846-4756
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 255880 MA Primary
Acute Care Nurse Practitioner 363LA2100X 2007007224-28 MA

Addresses

Primary practice location

300 Birnie Ave
Springfield, MA 01107-1107

Mailing address

300 Birnie Ave
Suite 201
Springfield, MA 01107-1107
Phone (413) 785-4666

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000062 MA Practitioner - Nurse Practitioner 8729143805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2007
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)

280 Chestnut St
Suite 2
Springfield, MA 01199-1001

40 Wright St
Palmer, MA 01069-1138
Phone (413) 370-5356

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 794-8121

759 Chestnut St
Springfield, MA 01199-1001
Phone (413) 794-5439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
255880MAMDNurse Practitioner
2007007224-28MAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Nurse Practitioner CurrentSince Oct 1, 2010 Accepting new patients
Baystate Affiliated Practice Organization Nurse Practitioner Past Accepting new patients

Locations

48 Sanderson St
Greenfield, MA 01301
Phone (413) 773-2022

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

300 Birnie Ave
Springfield, MA 01107
Phone (413) 736-5649

300 Birnie Ave
Ste 201
Springfield, MA 01107
Phone (413) 233-1292

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

85 South St
Ware, MA 01082
Phone (413) 967-2201

115 W Silver St
Westfield, MA 01085
Phone (413) 562-3444

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1952564981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE",
            "address_2": "SUITE 201",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071107",
            "telephone_number": "413-785-4666",
            "fax_number": "413-846-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BIRNIE AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071107",
            "telephone_number": "413-785-4666",
            "fax_number": "413-846-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAILLE",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "255880",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "2007007224-28",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.