| Mascoma Community Healthcare Inc | |
| 
					18 Roberts Road Canaan NH 03741  | |
| (603) 523-4501 | |
| Not Available | 
| Full Name | Mascoma Community Healthcare Inc | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 18 Roberts Road, Canaan, New Hampshire | 
| Authorized Official Name and Position | Michael Samson (FINANCE MANAGER) | 
| Authorized Official Contact | 6035234501 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mascoma Community Healthcare Inc Po Box 550 Canaan NH 03741-0550 Ph: (603) 523-4501  | Mascoma Community Healthcare Inc 18 Roberts Road Canaan NH 03741 Ph: (603) 523-4501  | 
| NPI Number | 1497298087 | 
|---|---|
| Provider Enumeration Date | 11/30/2016 | 
| Last Update Date | 03/08/2024 | 
| Medicare PECOS PAC ID | 2466736525 | 
|---|---|
| Medicare Enrollment ID | O20170309000707 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497298087 | NPI | - | NPPES | 
| Provider Name | Carrie M Webber | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1245372721 PECOS PAC ID: 8022039882 Enrollment ID: I20051208000713  | 
| Provider Name | Ellis B Gardner | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1932130630 PECOS PAC ID: 2163706227 Enrollment ID: I20170309000863  | 
| Provider Name | Frederick K Wiese | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1194739672 PECOS PAC ID: 0547340853 Enrollment ID: I20190410002560  | 
| Provider Name | Isabel D Watts | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1073122297 PECOS PAC ID: 0749698207 Enrollment ID: I20210421002140  | 
| Provider Name | Rachel M Hansen | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1407586969 PECOS PAC ID: 4183007909 Enrollment ID: I20220811001726  | 
| Provider Name | Mona Elzarka | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1144454760 PECOS PAC ID: 0941746374 Enrollment ID: I20240722003746  | 
| Provider Name | Kristen Taylor Gallub | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1679260798 PECOS PAC ID: 6305372459 Enrollment ID: I20241212000906  | 
| Provider Name | Morgan Ritchie | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1346926607 PECOS PAC ID: 7315309143 Enrollment ID: I20250108004211  | 
| Provider Name | Thomas Duplinsky | 
|---|---|
| Provider Type | Practitioner - Dentist | 
| Provider Identifiers | NPI Number: 1649319708 PECOS PAC ID: 1557515814 Enrollment ID: I20250109000738  |