MATTAPAN COMMUNITY HEALTH CENTER (NPI# 1962889162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962889162 |
| Entity Type | Organization |
| Organization Name | MATTAPAN COMMUNITY HEALTH CENTER |
| Practice Address |
1575 Blue Hill Ave Mattapan MA 02126-2122 |
| Practice Telephone | 6172960061 |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2015-04-27 |
| Authorized Official Name | MR. HENRY WORKMAN (DIRECTOR) |
| Authorized Official Telephone | 6178989041 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
88716 | MA | Ambulatory Health Care Facilities |
| Street Address |
1575 BLUE HILL AVE |
| City | MATTAPAN |
| State | MA |
| Zip Code | 02126-2122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730184854 | Christopher W Shanahan | Internal Medicine | 1575 Blue Hill Ave, Mattapan, MA 02126-2122 | 2005-06-15 |
| 1467003319 | Hyun-kee Harry Lee | Dentist | 1575 Blue Hill Ave, Mattapan, MA 02126-2122 | 2019-09-23 |
| 1316448467 | Laverne Lydia Dickson | Nurse Practitioner | 1575 Blue Hill Ave, Mattapan, MA 02126-2122 | 2018-02-23 |
| 1508318924 | Sarah Lennox | Social Worker | 1575 Blue Hill Ave, Mattapan, MA 02126 | 2016-11-02 |
| 1467909622 | Jessica Matthews | Social Worker | 1575 Blue Hill Ave, Mattapan, MA 02126-2122 | 2016-09-06 |
| 1467817726 | Tiniya Fulks | Dental Hygienist | 1575 Blue Hill Ave, Mattapan, MA 02126-2122 | 2015-12-30 |
| 1790191815 | Khara C Gresham | Dentist | 1575 Blue Hill Ave, Mattapan, MA 02126-2122 | 2014-07-09 |
| 1407295520 | Jennifer Kusner | Dentist | 1575 Blue Hill Ave, Mattapan, MA 02126-2122 | 2013-06-21 |
| 1912344300 | Taffidy Joy Berrouette | Social Worker | 1575 Blue Hill Ave, Mattapan, MA 02126 | 2013-05-27 |
| 1356786735 | Quest Diagnostics Massachusetts LLC | Clinical Medical Laboratory | 1575 Blue Hill Ave, Mattapan, MA 02126-2253 | 2013-04-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184280646 | Covil Home Care LLC | In Home Supportive Care | 1549 Blue Hill Ave, Mattapan, MA 02126 | 2019-05-10 |
| 1902374069 | Kasha Sarette | Social Worker | 37 Babson St, Mattapan, MA 02126 | 2018-11-07 |
| 1093231359 | Danielle Christian | Behavior Technician | 73 Catbird Ct, Mattapan, MA 02126 | 2017-08-18 |
| 1609314681 | Regis College | Hospice, Inpatient | 19 Southmere Road, Mattapan, MA 02126 | 2017-02-09 |
| 1437606001 | Betsy-lynn Ngole | Community Health Worker | 137 Savannah Ave, Boston, MA 02126 | 2016-09-01 |
| 1437535440 | Rosel Forwang Lewis | Registered Nurse | 42 Hallowell St, Mattapan, MA 02126 | 2015-08-03 |
| 1033596895 | Quality Home Care & Transportation | Transportation Broker | 93 W Selden St, Mattapan, MA 02126 | 2015-04-30 |
| 1205101565 | Clayton Mark Sandiford | Contractor | 22 Banfield Ave, Boston, MA 02126 | 2012-03-19 |
| 1790093128 | Richard Christopher Mitchell Jr. | Counselor | 32 Wellington Hill St, Mattapan, MA 02126 | 2010-09-20 |
| 1972630622 | Gemima St. Louis | Psychologist | 255 River St, Spark Center-bmc, Mattapan, MA 02126 | 2007-02-28 |
| Find all providers in zip 02126 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528575628 | Mattapan Dental, LLC | Clinic/Center | 542 River St, Mattapan, MA 02126-3014 | 2018-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265771 | Sidhu Family Dental LLC | Clinic/Center | 15 West St Ste 101, Douglas, MA 01516-2160 | 2020-11-04 |
| 1205436276 | The Nurture Frenectomy Center | Clinic/Center | 200 Elm St Ste 1, Pittsfield, MA 01201-6551 | 2020-10-29 |
| 1417557463 | Marva Khalid Dentistry PC | Clinic/Center | 105 Chestnut St Ste 25, Needham, MA 02492-2520 | 2020-10-29 |
| 1417555855 | Gardner Smiles Pllc | Clinic/Center | 356 Timpany Blvd, Gardner, MA 01440-5200 | 2020-10-16 |
| 1326646399 | Restoration Smiles, P.C. | Clinic/Center | 2 Coolidge St Ste 202, Hudson, MA 01749-1459 | 2020-10-13 |
| 1295333573 | Brian P. Ganley, Dmd, PC | Clinic/Center | 134 Main St Unit 1c, Groton, MA 01450-1375 | 2020-10-09 |
| 1619583168 | Newton Wellesley Dental Group LLC | Clinic/Center | 447 Centre Street, Same, Newton, MA 02458 | 2020-09-21 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1831703099 | Beacon Dental Health PC | Clinic/Center | 80 Washington St Bldg B, Norwell, MA 02061-1740 | 2020-09-04 |
| 1487267282 | Shoe City Family Dental PC | Clinic/Center | 103 Merrimack St, Haverhill, MA 01830-6208 | 2020-08-31 |
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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.