MEDICARE: BAYSTATE MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	2339	MA
2	261QC1500X	Community Health Clinic/Center	2339	MA
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	0109	MA
4	282N00000X	General Acute Care Hospital	2339	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487655064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYSTATE MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	759 CHESTNUT ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1001
Country	:	US
Telephone Number	:	413-794-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	759 CHESTNUT ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1001
Country	:	US
Telephone Number	:	413-794-0000
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	LAURIE MARTIN
Credential	:
Telephone Number	:	413-794-0000

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	08/06/2025

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Directions to “BAYSTATE MEDICAL CENTER INC ” Practice Location

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