| Sleep Medicine Services Of Western Massachusetts Llc | |
|
3640 Main St Ste 208 Springfield MA 01107-1192 | |
| (413) 253-2767 | |
| (413) 253-9767 |
| Full Name | Sleep Medicine Services Of Western Massachusetts Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3640 Main St Ste 208, Springfield, Massachusetts |
| Authorized Official Name and Position | Brian Smith (OWNER) |
| Authorized Official Contact | 4132532767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sleep Medicine Services Of Western Massachusetts Llc 3640 Main St Ste 208 Springfield MA 01107-1192 Ph: (413) 253-2767 | Sleep Medicine Services Of Western Massachusetts Llc 3640 Main St Ste 208 Springfield MA 01107-1192 Ph: (413) 253-2767 |
| NPI Number | 1750332771 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5092737098 |
|---|---|
| Medicare Enrollment ID | O20051219000588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750332771 | NPI | - | NPPES |
| 9752901 | Medicaid | MA | |
| M19058 | Other | MA | BCBS MA |
| 5510880001 | Other | MA | HEALTH NOW |
| 623943 | Other | MA | TUFTS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Robert R Ajello |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518930916 PECOS PAC ID: 7214975580 Enrollment ID: I20050419000380 |
| Provider Name | Neil D Bach |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1407819626 PECOS PAC ID: 6406889013 Enrollment ID: I20050914000853 |
| Provider Name | Rani U Athreya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114000734 PECOS PAC ID: 6608800115 Enrollment ID: I20050923000702 |
| Provider Name | Paul J Walting |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275503666 PECOS PAC ID: 0143223107 Enrollment ID: I20080808000165 |
| Provider Name | Donald W Blair |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1609894104 PECOS PAC ID: 5698942894 Enrollment ID: I20120111000237 |
| Provider Name | Michelle L Sheehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053742098 PECOS PAC ID: 0446476014 Enrollment ID: I20140717001766 |
| Provider Name | Jessica Marie Lafleche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073025136 PECOS PAC ID: 8224394655 Enrollment ID: I20171117000670 |
| Provider Name | Tana Bao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205479912 PECOS PAC ID: 9638502594 Enrollment ID: I20191206000396 |
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