Healthcare Provider Details
I. General information
NPI: 1124080353
Provider Name (Legal Business Name): JAYNE ROHRBACHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
532 SUMNER AVE
SPRINGFIELD MA
01108-2458
US
IV. Provider business mailing address
532 SUMNER AVE
SPRINGFIELD MA
01108-2458
US
V. Phone/Fax
- Phone: 413-739-1100
- Fax: 413-737-1643
- Phone: 413-739-1100
- Fax: 413-737-1643
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 71542 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 13327 |
| License Number State | NH |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 000000049358 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | BMC HEALTH NET PLAN |
| # 2 | |
| Identifier | 1124080353 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | TUFTS (BAYCARE PARTNERS) |
| # 3 | |
| Identifier | 71542 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | LICENSE |
| # 4 | |
| Identifier | 6247326 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | CIGNA |
| # 5 | |
| Identifier | AA126382 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | HARVARD PILGRIM |
| # 6 | |
| Identifier | 1124080353 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | NHP |
| # 7 | |
| Identifier | 38150 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | HNE |
| # 8 | |
| Identifier | MR0617918A |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | STATE CSR |
| # 9 | |
| Identifier | 071542 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | CONNECTICARE |
| # 10 | |
| Identifier | 1124080353 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | FALLON CARE (BAYCARE PARTNERS) |
| # 11 | |
| Identifier | 96632902 |
| Identifier Type | OTHER |
| Identifier State | MA |
| Identifier Issuer | NETWORK HEALTH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
