DR. KIMBALL A PRENTISS MD NPI 1972555670

NPI Information

NPI: 1972555670
Provider Name: DR. KIMBALL A PRENTISS, MD
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
759 CHESTNUT ST
SPRINGFIELD, MA
ZIP 01199
Phone: (413) 794-3233
Get Directions

DR. Kimball A Prentiss, MD is a pediatric emergency medicine pediatrics in Springfield, MA. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. DR. Kimball A Prentiss, MD NPI is 1972555670. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

759 CHESTNUT ST
SPRINGFIELD, MA
ZIP 01199-619
Phone: (413) 794-3233
Fax: (413) 794-9060

The NPI 1972555670 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 3/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		224057	MASSACHUSETTS	No
2	2080P0204X	Pediatrics	Pediatric Emergency Medicine	224057	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110041041A	MEDICAID	MASSACHUSETTS
2	A3863801	MEDICARE PIN	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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