1043292089 NPI number — DR. MARK ALBERT BIGDA DO

Table of content: DR. MARK ALBERT BIGDA DO (NPI 1043292089)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043292089 NPI number — DR. MARK ALBERT BIGDA DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIGDA
Provider First Name:
MARK
Provider Middle Name:
ALBERT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043292089
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
179 NORTHAMPTON ST STE D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EASTHAMPTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01027-1057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-529-9282
Provider Business Mailing Address Fax Number:
413-527-7526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
179 NORTHAMPTON ST STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01027-1057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-529-9282
Provider Business Practice Location Address Fax Number:
413-527-7526
Provider Enumeration Date:
11/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  71687 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110074429 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110074429 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 724707 . This is a "CONNECTICARE SELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000008032 . This is a "BOSTON MEDICAL HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 10615 . This is a "HEALTH NEW ENGLAND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 732090 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: M18221 . This is a "BLUECROSS BLUESHIELD GRP" identifier . This identifiers is of the category "OTHER".
  • Identifier: J09439 . This is a "BLUECROSS BLUESHIELD IND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21N80 . This is a "EMPIRE BC BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3058581 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10250601 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 62810 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2037537 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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