| Upham's Corner Health Committee, Inc. | |
|
500 Columbia Rd Dorchester MA 02125-2322 | |
| (617) 287-8000 | |
| (617) 282-8625 |
| Full Name | Upham's Corner Health Committee, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 Columbia Rd, Dorchester, Massachusetts |
| Authorized Official Name and Position | Jagdeep Trivedi (CEO) |
| Authorized Official Contact | 6177408131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upham's Corner Health Committee, Inc. 500 Columbia Rd Dorchester MA 02125-2322 Ph: (617) 287-8000 | Upham's Corner Health Committee, Inc. 500 Columbia Rd Dorchester MA 02125-2322 Ph: (617) 287-8000 |
| NPI Number | 1780780486 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 07/12/2017 |
| Medicare PECOS PAC ID | 4284645086 |
|---|---|
| Medicare Enrollment ID | O20060508000841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780780486 | NPI | - | NPPES |
| 1301977 | Medicaid | MA |
| Provider Name | Grier H Merwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255378204 PECOS PAC ID: 7113968405 Enrollment ID: I20050517000670 |
| Provider Name | Richard C Bird |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316040603 PECOS PAC ID: 0547202533 Enrollment ID: I20050601000092 |
| Provider Name | Paul L Geltman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942367206 PECOS PAC ID: 5395780993 Enrollment ID: I20050623000873 |
| Provider Name | Geoffrey Modest |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023002169 PECOS PAC ID: 5193757599 Enrollment ID: I20050907000363 |
| Provider Name | Dawn A Fraser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548335698 PECOS PAC ID: 9830199702 Enrollment ID: I20061228000332 |
| Provider Name | Olga L De La Calle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548310667 PECOS PAC ID: 1355427873 Enrollment ID: I20080325000251 |
| Provider Name | Elise Marie Henricks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154392850 PECOS PAC ID: 4183748676 Enrollment ID: I20100907000418 |
| Provider Name | Elisabeth J Moths-rebrovic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558332270 PECOS PAC ID: 9638350663 Enrollment ID: I20110224000405 |
| Provider Name | Marjorie Anne Janvier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598931628 PECOS PAC ID: 0042494379 Enrollment ID: I20110412000462 |
| Provider Name | Phuong T Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164855698 PECOS PAC ID: 5991933004 Enrollment ID: I20140117001654 |
| Provider Name | Jennifer K Le |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538599014 PECOS PAC ID: 7517197353 Enrollment ID: I20140224000788 |
| Provider Name | Monique Willett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568512358 PECOS PAC ID: 2860671476 Enrollment ID: I20140416000117 |
| Provider Name | Lucy M Lomas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184854432 PECOS PAC ID: 5496970295 Enrollment ID: I20140711000987 |
| Provider Name | Mai-khuyen Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407297815 PECOS PAC ID: 4183849748 Enrollment ID: I20140715002623 |
| Provider Name | Meredith Amos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356609150 PECOS PAC ID: 7618109596 Enrollment ID: I20150922001567 |
| Provider Name | Pooja R Raval |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043570336 PECOS PAC ID: 1052543964 Enrollment ID: I20151223000529 |
| Provider Name | Claudia A Clarke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558621359 PECOS PAC ID: 8729386776 Enrollment ID: I20180615000262 |
| Provider Name | Eliot Cohen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366430779 PECOS PAC ID: 4981866647 Enrollment ID: I20180705000247 |
| Provider Name | Emmeline Siebert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720514979 PECOS PAC ID: 6608126362 Enrollment ID: I20180830002133 |
| Provider Name | Emily S Lowenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932487014 PECOS PAC ID: 4789847963 Enrollment ID: I20180917000793 |
| Provider Name | Madeleine G Bayne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487132791 PECOS PAC ID: 5395096317 Enrollment ID: I20181001001949 |
| Provider Name | Benjamin Michael Grin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922489145 PECOS PAC ID: 6002102076 Enrollment ID: I20181012000025 |
| Provider Name | Rachel L Lovett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609355338 PECOS PAC ID: 0749534733 Enrollment ID: I20181109001412 |
| Provider Name | Jalena C Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467998682 PECOS PAC ID: 9234474842 Enrollment ID: I20181228001512 |
| Provider Name | Emily Curley |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558711937 PECOS PAC ID: 7911294012 Enrollment ID: I20190201000326 |
| Provider Name | June-ho Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235549296 PECOS PAC ID: 5799090940 Enrollment ID: I20190225002513 |
| Provider Name | Margaret L Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669445425 PECOS PAC ID: 0941469902 Enrollment ID: I20190227002601 |
| Provider Name | Sarah L Conca |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902108384 PECOS PAC ID: 9436488665 Enrollment ID: I20190912001644 |
| Provider Name | Megan E O'keefe |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1265809701 PECOS PAC ID: 4082953252 Enrollment ID: I20190923002152 |
| Provider Name | Caitlin Reagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407358088 PECOS PAC ID: 6507298734 Enrollment ID: I20191108002535 |
| Provider Name | Hannah Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952961583 PECOS PAC ID: 5395178735 Enrollment ID: I20191126000121 |
| Provider Name | Jennifer Ruth Prentiss |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1750923744 PECOS PAC ID: 2264869312 Enrollment ID: I20200302000698 |
| Provider Name | Allison M Wisbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912583030 PECOS PAC ID: 9032510748 Enrollment ID: I20210701000162 |
| Provider Name | Kellie St Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598305807 PECOS PAC ID: 3678976313 Enrollment ID: I20210719003217 |
| Provider Name | Muna S Sheikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689029860 PECOS PAC ID: 4981999364 Enrollment ID: I20221027002992 |
| Provider Name | Hanieh Yaghoobi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619493160 PECOS PAC ID: 9739550500 Enrollment ID: I20230116000268 |
| Provider Name | Abigail R Rezendes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538795935 PECOS PAC ID: 4981079035 Enrollment ID: I20230404000817 |
| Provider Name | Sarah Castaneda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669878963 PECOS PAC ID: 3476928441 Enrollment ID: I20230404002157 |
| Provider Name | Jason Lanier Outlaw |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184144651 PECOS PAC ID: 9032574686 Enrollment ID: I20230503002740 |
| Provider Name | Hyang L Han |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972943181 PECOS PAC ID: 2264821693 Enrollment ID: I20230831000353 |
| Provider Name | Jacquelyn A Quarles-joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396492872 PECOS PAC ID: 2466815865 Enrollment ID: I20230901001447 |
| Provider Name | Yessica Labour Aguasvivas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427738533 PECOS PAC ID: 1557716511 Enrollment ID: I20231011000743 |
| Provider Name | Sarrin E List |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225408875 PECOS PAC ID: 6406117670 Enrollment ID: I20231011003604 |
| Provider Name | Jennifer Herrera Cordones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215617311 PECOS PAC ID: 3476900986 Enrollment ID: I20231106000608 |
| Provider Name | Shakeila L Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386200947 PECOS PAC ID: 9931556479 Enrollment ID: I20231106001865 |
| Provider Name | Nia Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457009763 PECOS PAC ID: 2062869951 Enrollment ID: I20231115000700 |
| Provider Name | Eunice C Freire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083391577 PECOS PAC ID: 1153773205 Enrollment ID: I20240115000764 |
| Provider Name | Shellie M Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891136636 PECOS PAC ID: 0648405928 Enrollment ID: I20240213002098 |
| Provider Name | Rita L Nieves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336369412 PECOS PAC ID: 6901235514 Enrollment ID: I20240503001636 |
| Provider Name | Sydney L Appelbaum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265004006 PECOS PAC ID: 8628510922 Enrollment ID: I20240601000186 |
| Provider Name | Amber E Frost |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417502337 PECOS PAC ID: 3577005495 Enrollment ID: I20240606003916 |
| Provider Name | Haley E Korn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548786700 PECOS PAC ID: 9638612385 Enrollment ID: I20240621002987 |
| Provider Name | Lane Olivia Davenport |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184460487 PECOS PAC ID: 1254871619 Enrollment ID: I20240911004556 |
| Provider Name | Kyla V Rockland-miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043825235 PECOS PAC ID: 6002297959 Enrollment ID: I20241217001864 |
| Provider Name | Luis E Correia Alves |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700535275 PECOS PAC ID: 9133657844 Enrollment ID: I20250109000032 |
| Provider Name | Yarit Vega |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1699528463 PECOS PAC ID: 3173053253 Enrollment ID: I20250204002599 |
| Provider Name | Emilys Y Romero-arias |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1093526394 PECOS PAC ID: 3072043876 Enrollment ID: I20250210000590 |
Davis Square Dental Specialists Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1792 Dorchester Ave, Dorchester, MA 02124 Phone: 617-265-8338 | |
Han M Le Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1510 Dorchester Ave, Dorchester, MA 02122 Phone: 617-288-7600 | |
Sage Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 Washington Street, Dorchester, MA 02121 Phone: 617-446-3998 | |
Family Dental Care, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1444 Dorchester Ave, Dorchester, MA 02122 Phone: 617-436-7030 Fax: 617-265-7295 | |
Metropolitan Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1417 Dorchester Ave, Dorchester, MA 02122 Phone: 617-929-0600 | |
Frank Y. Shin, Dmd, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1428 Dorchester Ave, Dorchester, MA 02122 Phone: 617-265-5606 Fax: 617-265-3803 | |
Lt Dental, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1470 Dorchester Ave., Dorchester, MA 02122 Phone: 617-997-3826 |