UPHAM'S CORNER HEALTH COMMITTEE, INC. (NPI# 1780780486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780780486 |
| Entity Type | Organization |
| Organization Name | UPHAM'S CORNER HEALTH COMMITTEE, INC. |
| Other Organization Name | UPHAM'S CORNER HEALTH CENTER |
| Practice Address |
500 Columbia Rd Dorchester MA 02125-2322 |
| Practice Telephone | 6172878000 |
| Practice Fax Number | 6172828625 |
| Mailing Telephone | 6172878000 |
| Mailing Fax Number | 6172828625 |
| Enumeration Date | 2006-09-16 |
| 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 |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| N | 292200000X | Dental Laboratory | Laboratories | ||
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
| N | 261QF0050X |
Clinic/Center Specialization: Family Planning, Non-Surgical |
Ambulatory Health Care Facilities | ||
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
490 | MA | Ambulatory Health Care Facilities |
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QP1100X |
Clinic/Center Specialization: Podiatric |
Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1301977 | 05 |
| Other Name | Type Code |
|---|---|
| Upham's Corner Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316023195 | Upham's Corner Health Committee, Inc. | PACE Provider Organization | 1140 Dorchester Ave, Dorchester, MA 02125-3305 | 2006-10-27 |
| Street Address |
500 COLUMBIA RD |
| City | DORCHESTER |
| State | MA |
| Zip Code | 02125-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023002169 | Geoffrey Alan Modest | Family Medicine | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2005-09-05 |
| 1164072708 | Chavely Rijo | Registered Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2019-09-16 |
| 1538627757 | Chrisler C Thornhill | Registered Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2019-03-06 |
| 1932694718 | Nicole Leeann Smith | Licensed Practical Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2018-06-25 |
| 1518313683 | Cristina Fernandes | Registered Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2016-05-09 |
| 1457719031 | Ella Stemmer | Nurse Practitioner | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2016-02-10 |
| 1912383753 | Shelly Emile | Registered Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2015-08-04 |
| 1952794869 | Nasra Adan | Registered Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2015-03-17 |
| 1639577679 | Emmanuel Kamonou | Registered Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2014-12-08 |
| 1093142523 | Julieanne Burridge | Registered Nurse | 500 Columbia Rd, Dorchester, MA 02125-2322 | 2013-09-30 |
| 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 | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881692366 | Harbor Health Services, Inc. | Clinic/Center | 398 Neponset Ave, Dorchester, MA 02122-3134 | 2005-07-08 |
| 1780874677 | Boston Medical Center Corporation | Clinic/Center | 1353 Dorchester Ave, Dorchester, MA 02122-2932 | 2007-07-27 |
| 1790804623 | Beth Israel Deaconess Medical Cenetr | Clinic/Center | 230 Bowdoin St, Dorchester, MA 02122-1817 | 2007-03-29 |
| 1093867863 | Bowdoin Street Health Ceneter | Clinic/Center | 230 Bowdoin St, Dorchester, MA 02122-1817 | 2007-01-18 |
| 1659330496 | Harbor Health Services Inc | Clinic/Center | 250 Mount Vernon St, Dorchester, MA 02125 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083171805 | Community Health Center of Cape Cod, Inc. | Clinic/Center | 115 Scranton Ave, Falmouth, MA 02540-3560 | 2019-02-28 |
| 1811490790 | Trustees of Tufts College | Clinic/Center | 200 Harrison Ave Fl 2, Boston, MA 02111 | 2018-03-16 |
| 1073993937 | Greater New Bedford Community Health Center, Inc. | Clinic/Center | 135 Marion Rd, Wareham, MA 02571-1423 | 2015-06-05 |
| 1619369022 | Melissa Quast | Clinic/Center | 151 Run Hill Rd, Brewster, MA 02631-2374 | 2015-02-22 |
| 1992001457 | Mashpee Service Unit/indian Health Service | Clinic/Center | 483 Great Neck Road South, Building 002-health Clinic, Mashpee, MA 02649 | 2011-02-01 |
| 1407086937 | Springfield Dept of Health & Human Services | Clinic/Center | 769 Worthington Street, Hsh Dental Clinic, Springfeld, MA 01105-1112 | 2009-07-17 |
| 1619143500 | Lowell General Hospital | Clinic/Center | 295 Varnum Ave Rm 75, Lowell, MA 01854-2134 | 2008-05-01 |
| 1891816930 | Sunrise-amanecer Inc. | Clinic/Center | 19 Milford St, Springfield, MA 01107-1332 | 2007-04-03 |
| 1033257522 | Lemuel Shattuck Hosp | Clinic/Center | 9 Brewer St, Jamaica Plain, MA 02130-4032 | 2007-02-05 |
| 1932266533 | Roxbury Comprehensive Community Health Center, Inc. | Clinic/Center | 435 Warren St, Roxbury, MA 02119-1833 | 2007-01-02 |
| Find all providers with the same taxonomy | ||||
| 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.