NORTHERN BERKSHIRE SPORTS MEDICINE INC
NPI 1750440277
Specialist in North Adams, MA

NPI Status: Active since December 08, 2006

Contact Information

40 MAIN STREET
SUITE 103
NORTH ADAMS, MA
ZIP 01247
Phone: (413) 663-5450
Fax: (413) 664-8737

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  • Organization
  • Specialist
  • CLIA Number: 22D2075619
  • CLIA Cert. Type: Hospital
  • CLIA Exp. Date: 08-25-2025

About NORTHERN BERKSHIRE SPORTS MEDICINE INC

This page provides the complete NPI Profile along with additional information for Northern Berkshire Sports Medicine Inc, a provider established in North Adams, Massachusetts operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1750440277 assigned on December 2006. The practitioner's primary taxonomy code is 174400000X with license number 053990 (MA). The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Paul J Donovan Do (Medical Director)

NPI
1750440277
Provider Name
NORTHERN BERKSHIRE SPORTS MEDICINE INC
Entity Type
Organization
Location Address
40 MAIN STREET SUITE 103 NORTH ADAMS, MA 01247
Location Phone
(413) 663-5450
Location Fax
(413) 664-8737
Mailing Address
40 MAIN STREET SUITE 103 NORTH ADAMS, MA 01247
Mailing Phone
(413) 663-5450
Mailing Fax
(413) 664-8737
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-08-2006
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
053990
License State
MA
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. PAUL J DONOVAN DO

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(413) 663-5450

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
M15970OTHER (01)MABLUE SHIELD GROUP NUMBER
9773398MEDICAID (05)MA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
22D2075619
Facility Type
Hospital
Certificate Effective Date
August 26, 2023
Certificate Expiration Date
August 25, 2025
Laboratory Director
DR. DAVID JONES
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Northern Berkshire Sports Medicine Inc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1750440277
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27100840214
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 8 + 4 + 0 + 2 + 1 + 4 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1750440277 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750440277, enumerated in the NPI registry as an "organization" on December 08, 2006

The provider is located at 40 Main Street Suite 103 North Adams, Ma 01247 and the phone number is (413) 663-5450

This medical organization specializes in Specialist with taxonomy code 174400000X

The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 22D2075619 for a "hospital" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..

This NPI record was last updated on December 08, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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