UPHAM'S CORNER HEALTH COMMITTEE, INC. (NPI# 1316023195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316023195 |
| Entity Type | Organization |
| Organization Name | UPHAM'S CORNER HEALTH COMMITTEE, INC. |
| Other Organization Name | UPHAM'S ELDER SERVICE PLAN |
| Practice Address |
1140 Dorchester Ave Dorchester MA 02125-3305 |
| Mailing Address |
500 Columbia Rd Dorchester MA 02125-2322 |
| Practice Telephone | 6172880970 |
| Practice Fax Number | 6174740757 |
| Mailing Telephone | 6172880970 |
| Mailing Fax Number | 6172828625 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2017-07-12 |
| Authorized Official Name | MR. JAGDEEP TRIVEDI (CEO) |
| Authorized Official Telephone | 6177408131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1803344 | 05 |
| Other Name | Type Code |
|---|---|
| Upham's Elder Service Plan | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780780486 | Upham's Corner Health Committee, Inc. | Clinical Medical Laboratory | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2006-09-16 |
| Street Address |
1140 DORCHESTER AVE |
| City | DORCHESTER |
| State | MA |
| Zip Code | 02125-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689634859 | Deborah Jane Barnes | Nurse Practitioner | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2006-03-23 |
| 1679984017 | Kathleen Spehar Byron | Social Worker | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2014-05-19 |
| 1952543241 | Caroline A Orofo | Registered Nurse | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2009-04-01 |
| 1457521379 | Mariah Reid Daly | Registered Nurse | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2008-03-06 |
| 1780864744 | Rachel Autumn Pitot | Registered Nurse | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2007-11-07 |
| 1811198112 | Jan Emily Wiley-egdall | Social Worker | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2007-05-31 |
| 1053512277 | Irlande Plancher | Registered Nurse | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2007-05-29 |
| 1851466270 | Frederica Davis Eder | Occupational Therapist | 1140 Dorchester Ave, Uphams Elder Service Plan, Dorchester, MA 02125 | 2006-11-21 |
| 1518043447 | Jacinta Uchenna Ndugba | Registered Nurse | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2006-10-31 |
| 1801972724 | Obiamaka Regina Ntukogu | Registered Nurse | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2006-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922520840 | Aj Guerrero | Counselor | 6 Glen St. #3, Boston, MA 02125 | 2017-07-12 |
| 1982059218 | Ana Fernandez | Psychologist | University of Massachusetts, Boston, 100 William T. Morrissey Blvd, Boston, MA 02125 | 2016-04-23 |
| 1558725184 | Algecira Garcia-ortiz | Massage Therapist | 12 Judson St, Dorchester, MASSACHUSETTS 02125 | 2016-04-10 |
| 1508251414 | Sing Hong Ty | Registered Nurse | 415 Colombia Rd, Dorchester, MA 02125 | 2015-03-30 |
| 1972806750 | Joanne Pomales | Counselor | 18 Harbor Crest Court 102, Dorchester, MA 02125 | 2010-12-16 |
| 1386969335 | Kara Jillian Sheridan | Counselor | 58 Dorset St, Boston, MA 02125 | 2010-04-02 |
| 1750533956 | Wendy M. Jern | Physical Therapist | 21riley Rd #2, Hyde Park, MA 02125 | 2008-10-21 |
| 1174729743 | Payton Brandyberry | Counselor | 500 Columbia Rd, Mail Stop 415-05, Upham's Corner Health Center, Dorchester, MA 02125 | 2007-06-21 |
| 1699817247 | Dong Lan Corporation | Pharmacist | 1167 A Dorchester Ave, Dorchester, MA 02125 | 2007-02-12 |
| 1457490153 | Sarah L Merin | Social Worker | Upham's Corner Health Center, 500 Columbia Rd, Mailstop 415-05, Dorchester, MA 02125 | 2007-02-06 |
| Find all providers in zip 02125 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477992865 | Ann's Guardian Angels | PACE Provider Organization | 1815 Falmouth Rd, B5, Centerville, MA 02632-3163 | 2013-06-18 |
| 1104199850 | Mercy Life, Incorporated | PACE Provider Organization | 2112 Riverdale St, West Springfield, MA 01089-1024 | 2012-02-10 |
| 1114054988 | East Boston Neighborhood Health Center Elder Service Plan | PACE Provider Organization | 10 Gove St, East Boston, MA 02128-1920 | 2007-02-27 |
| 1376696674 | Fallon Community Health Plan | PACE Provider Organization | 277 E Mountain St, Worcester, MA 01606-1207 | 2007-01-19 |
| 1477640324 | Visiting Nurse Association of Cape Cod, Inc. | PACE Provider Organization | 290 Route 130, Sandwich, MA 02563 | 2006-10-10 |
| City | DORCHESTER |
| Zip Code | 02125 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.