PASSPORT HEALTH HOLDINGS, LLC (NPI# 1528593761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528593761 |
| Entity Type | Organization |
| Organization Name | PASSPORT HEALTH HOLDINGS, LLC |
| Other Organization Name | PPH FRANCHISE HOLDINGS, LLC |
| Practice Address |
18 Tremont Street Suite 404 Boston MA 02108-2304 |
| Mailing Address |
8324 E Hartford Dr Ste 200 Scottsdale AZ 85255-7801 |
| Practice Telephone | 8773588648 |
| Practice Fax Number | 8778776875 |
| Mailing Telephone | 8773588648 |
| Mailing Fax Number | 8778776875 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |
| Authorized Official Name | MR. DOUG SHACKELL (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 4806469024 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PPH Franchise Holdings, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659912533 | Passport Health Holdings, LLC | Preventive Medicine | 111 Williard Street, Suite Gc, Quincy, MA 02169-1200 | 2019-10-02 |
| 1336793843 | Passport Health Holdings, LLC | Community Health Worker | 545 Mainstream Drvie, Suite 401, Nashville, TN 37228-1231 | 2019-08-01 |
| 1093369597 | Passport Health Holdings, LLC | Community Health Worker | 901 E Saint Louis Street, Suite 107, Springfield, MO 65806-2574 | 2019-08-01 |
| 1801440318 | Passport Health Holdings, LLC | Community Health Worker | 5330 North Oak Trafficway, Suite 105, Kansas City, MO 64118-4600 | 2019-08-01 |
| 1902450406 | Passport Health Holdings, LLC | Community Health Worker | 345 Boylston Street Floor 2, Suite 202, Newton, MA 02459-2863 | 2019-08-01 |
| 1346701075 | Passport Health Holdings, LLC | Preventive Medicine | 563 W 500 South, Suite 215, Bountiful, UT 84010-8172 | 2019-03-26 |
| 1972085587 | Passport Health Holdings, LLC | Clinic/Center | 3375 E. Capital Circle Ne Bldg E, Suite 3, Tallahassee, FL 32308-3778 | 2018-08-30 |
| 1619488103 | Passport Health Holdings, LLC | Community Health Worker | 14985 W Bell Rd Bldg 12-a, Surprise, AZ 85374-3231 | 2017-10-24 |
| 1578004008 | Passport Health Holdings, LLC | Preventive Medicine | 1116 E Route 66, Flagstaff, AZ 86001-4706 | 2017-03-16 |
| 1558802082 | Passport Health Holdings, LLC | Preventive Medicine | 2601 N. 3rd Street, Ste 102, Phoenix, AZ 85004-1145 | 2017-03-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PASSPORT HEALTH HOLDINGS, LLC | 8324 E. Hartford Dr. Ste. 200, Scottsdale, AZ 85255 |
| Street Address |
18 TREMONT STREET SUITE 404 |
| City | BOSTON |
| State | MA |
| Zip Code | 02108-2304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366947954 | Karrin Weisenthal | Emergency Medicine | 1 Boston Pl Rm 1322, Boston, MA 02108 | 2018-03-27 |
| 1619225786 | Ahmed M Hamada-ibrahim | Dentist | 32 Tremont Sytreet, Citidental, Boston, MA 02108 | 2012-08-21 |
| 1114226750 | Richard J Osorio | Counselor | 30 Winter Street, Boston Asap, Boston, MA 02108 | 2011-03-22 |
| 1487956835 | Melissa Jean Leite | Dental Hygienist | 250 Washington Street, Boston, MA 02108 | 2010-11-17 |
| 1518274117 | Ada Stefanescu | Internal Medicine | Mgh Downtown Associates, 294 Washington St Ste 210, Boston, MA 02108 | 2010-09-03 |
| 1679798599 | Lauren Carter Ledbetter | Social Worker | Ten Milk Street, Boston, MA 02108 | 2007-04-16 |
| 1790900157 | Lawrence K Gottlieb | Internal Medicine | Intermed Advisors Inc., One Boston Place, Suite 2815, Boston, MA 02108 | 2007-04-13 |
| 1285761841 | Gerardo A Yanayaco | Internal Medicine | Laser Hair Removal, LLC, 333 Washington Street, #221, Boston, MA 02108 | 2007-02-28 |
| 1295863603 | William F Sullivan | Counselor | Adcare, 14 Beacon Street, 801, Boston, MA 02108 | 2007-02-28 |
| 1659432573 | Madeleine I Littman | Psychologist | 15 Court Square, Suite 830, Boston, MA 02108 | 2006-12-13 |
| Find all providers in zip 02108 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609997857 | Sally J Heymann | Preventive Medicine | Harvard Sch Pub Health, 677 Huntington Ave, Boston, MA 02115 | 2007-04-03 |
| 1619010006 | Harris A Berman | Preventive Medicine | Tufts Univ School of Medicine, 136 Harrison Ave, Boston, MA 02111 | 2007-02-15 |
| 1740330786 | Meir J Stampfer | Preventive Medicine | Channing Laboratory, 181 Longwood Ave, Boston, MA 02445 | 2007-01-11 |
| 1518026970 | Anthony Robbins | Preventive Medicine | Tufts University, 136 Harrison Avenue, Boston, MA 02111 | 2006-12-08 |
| 1871692624 | Helen Holly Hackman | Preventive Medicine | 250 Washington St, 4th Floor, Boston, MA 02108-4603 | 2006-09-21 |
| 1780606608 | North End Community Health Committee Inc | Preventive Medicine | 332 Hanover Street, Boston, MA 02113 | 2006-07-24 |
| 1376580969 | Deborah B Prothrow-stith | Preventive Medicine | 841 Parker Street, Ground Floor, Boston, MA 02120 | 2006-06-01 |
| 1568412906 | Barry Paul Chaiken | Preventive Medicine | 14 Durham St, Boston, MA 02115-5301 | 2006-05-10 |
| 1679711030 | Elizabeth Dean-clower | Preventive Medicine | 44 Binney St, Swb Rm.560, Boston, MA 02115-6013 | 2009-01-22 |
| 1134319221 | Howard H Hiatt | Preventive Medicine | Brigham & Women's Hosp, Dept of Medicine, Boston, MA 02115 | 2007-07-26 |
| Find all providers in BOSTON | ||||
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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.