MEDICARE: WESTERN MASS PHYSICIAN ASSOCIATES INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	176B00000X	Midwife	MA
2	207V00000X	Obstetrics & Gynecology Physician	MA
3	208000000X	Pediatrics Physician	MA
4	207R00000X	Internal Medicine Physician	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CK1182	OTHER	MA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	T203	OTHER	HARVARD PILGRIM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	M15781	OTHER	BLUECARE 65
6	M15781	OTHER	BCBS OF MASS

General Provider Information

NPI Number	:	1922009547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN MASS PHYSICIAN ASSOCIATES INC

Provider Business Mailing Address
First Line	:	15 HOSPITAL DR
Second Line	:	WESTERN MASS PHYSICIAN ASSOCIATES, INC.
City	:	HOLYOKE
State	:	MA
Zip	:	01040-6606
Country	:	US
Telephone Number	:	413-533-3470
Fax Number	:	413-533-6859

Provider Business Practice Location Address
First Line	:	262 NEW LUDLOW RD
Second Line	:
City	:	CHICOPEE
State	:	MA
Zip	:	01020-4324
Country	:	US
Telephone Number	:	413-534-2622
Fax Number	:	413-534-2661

Authorized Official
Title or Position	:	VP OF AMBULATORY SERVICES
Name	:	MR. PHILLIP CANDITO
Credential	:
Telephone Number	:	413-534-2622

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	07/21/2022

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Directions to “WESTERN MASS PHYSICIAN ASSOCIATES INC ” Practice Location

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