| Manet Community Health Center, Inc. | |
| 
					110 W Squantum St North Quincy MA 02171-2122  | |
| (617) 376-3030 | |
| (617) 774-1906 | 
| Full Name | Manet Community Health Center, Inc. | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 110 W Squantum St, North Quincy, Massachusetts | 
| Authorized Official Name and Position | Cynthia Sierra (CHIEF EXECUTIVE OFFICER) | 
| Authorized Official Contact | 6174044101 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Manet Community Health Center, Inc. 110 W Squantum St North Quincy MA 02171-2122 Ph: (617) 376-3030  | Manet Community Health Center, Inc. 110 W Squantum St North Quincy MA 02171-2122 Ph: (617) 376-3030  | 
| NPI Number | 1114027539 | 
|---|---|
| Provider Enumeration Date | 09/25/2006 | 
| Last Update Date | 03/03/2023 | 
| Certification Date | 03/03/2023 | 
| Medicare PECOS PAC ID | 4486555158 | 
|---|---|
| Medicare Enrollment ID | O20040115000950 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1114027539 | NPI | - | NPPES | 
| 1302841 | Medicaid | MA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary | 
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 4801 (Massachusetts) | Primary | 
| Provider Name | Lily Y Yung | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1356319065 PECOS PAC ID: 3476518234 Enrollment ID: I20041122000571  | 
| Provider Name | Robert Joseph | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1104983659 PECOS PAC ID: 2466499595 Enrollment ID: I20050411000955  | 
| Provider Name | Iris C Wong | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1306837711 PECOS PAC ID: 9537102926 Enrollment ID: I20050607000400  | 
| Provider Name | Pamela Gordon | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1669463097 PECOS PAC ID: 9234172347 Enrollment ID: I20050608001018  | 
| Provider Name | Sarah J Benoit | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1801981295 PECOS PAC ID: 5698709780 Enrollment ID: I20050919000515  | 
| Provider Name | Jennifer F Sabir | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1427027275 PECOS PAC ID: 3870520380 Enrollment ID: I20060110000887  | 
| Provider Name | Jeanne Marie T Hopkins | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1205819174 PECOS PAC ID: 6608966429 Enrollment ID: I20071218000043  | 
| Provider Name | Timothy Comeaux | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1063563906 PECOS PAC ID: 5092898122 Enrollment ID: I20080213000462  | 
| Provider Name | Gail E Polli | 
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) | 
| Provider Identifiers | NPI Number: 1396898631 PECOS PAC ID: 9537248356 Enrollment ID: I20080506000214  | 
| Provider Name | Hannah-mariah W Severns | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1083802391 PECOS PAC ID: 5991845604 Enrollment ID: I20091210000319  | 
| Provider Name | Robert Shiner | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1801869375 PECOS PAC ID: 5799809778 Enrollment ID: I20100827000066  | 
| Provider Name | Joshua Okallo | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1598081762 PECOS PAC ID: 6507092277 Enrollment ID: I20131203000007  | 
| Provider Name | William R Brandon | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1770562548 PECOS PAC ID: 7517090558 Enrollment ID: I20140226001265  | 
| Provider Name | Vikram Butani | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1003129446 PECOS PAC ID: 5193985612 Enrollment ID: I20140905000035  | 
| Provider Name | Alison Tam | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1427378777 PECOS PAC ID: 7719119106 Enrollment ID: I20141010000792  | 
| Provider Name | Debi Sarma | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1164825063 PECOS PAC ID: 4183947294 Enrollment ID: I20141222001510  | 
| Provider Name | Karla A. Talledo Thais | 
|---|---|
| Provider Type | Practitioner - Infectious Disease | 
| Provider Identifiers | NPI Number: 1134357924 PECOS PAC ID: 4880919000 Enrollment ID: I20150211000730  | 
| Provider Name | Jessica D Bradford | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1962414599 PECOS PAC ID: 3779893185 Enrollment ID: I20151113000907  | 
| Provider Name | Nikita Fitzcharles | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1356607584 PECOS PAC ID: 3779883335 Enrollment ID: I20151203002097  | 
| Provider Name | Christine Basile | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1447629647 PECOS PAC ID: 0345544821 Enrollment ID: I20160203000881  | 
| Provider Name | Charles R Bell | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1932143534 PECOS PAC ID: 2769458967 Enrollment ID: I20160421000327  | 
| Provider Name | Kathleen M. Mcdevitt | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1497049282 PECOS PAC ID: 3971896820 Enrollment ID: I20160729000881  | 
| Provider Name | Kathleen Joyce Neimann | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1487109997 PECOS PAC ID: 9830478171 Enrollment ID: I20161109001924  | 
| Provider Name | Charlette Hines | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1518415785 PECOS PAC ID: 8224318837 Enrollment ID: I20161216000533  | 
| Provider Name | Ivy Kwanor Opoku-mensah | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1609234533 PECOS PAC ID: 1254613300 Enrollment ID: I20170227002169  | 
| Provider Name | Mary P Cahill | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1083065858 PECOS PAC ID: 3072897099 Enrollment ID: I20170310000848  | 
| Provider Name | Mary Ann Dakkak | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1326313776 PECOS PAC ID: 2668605296 Enrollment ID: I20171017003600  | 
| Provider Name | Chih Chao Yang | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1538574488 PECOS PAC ID: 2769774892 Enrollment ID: I20171028000182  | 
| Provider Name | Celeste Le | 
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional | 
| Provider Identifiers | NPI Number: 1750881777 PECOS PAC ID: 7911261789 Enrollment ID: I20180502000974  | 
| Provider Name | Katy E Bockstall | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1952676058 PECOS PAC ID: 0446507289 Enrollment ID: I20180724003896  | 
| Provider Name | Ream Akkeh | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1699277012 PECOS PAC ID: 0244580587 Enrollment ID: I20180906001555  | 
| Provider Name | Jane Farrell | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1972074474 PECOS PAC ID: 4688914203 Enrollment ID: I20190319000555  | 
| Provider Name | Katherine R Standish | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1306209168 PECOS PAC ID: 4880989045 Enrollment ID: I20190625000899  | 
| Provider Name | Kristen Dimauro | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1902397631 PECOS PAC ID: 9537491576 Enrollment ID: I20191024002003  | 
| Provider Name | Carol N Hamilton | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1740840610 PECOS PAC ID: 3577895218 Enrollment ID: I20191029002454  | 
| Provider Name | Brian T Kroener | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1205220126 PECOS PAC ID: 0840503850 Enrollment ID: I20191030002935  | 
| Provider Name | Ashley Amaral | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1598136707 PECOS PAC ID: 0749619559 Enrollment ID: I20200330003323  | 
| Provider Name | Claire Qingyi Paduano | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1699206375 PECOS PAC ID: 1759652191 Enrollment ID: I20200604000217  | 
| Provider Name | Alexandra Therese Tarabochia-gast | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1134651433 PECOS PAC ID: 9638440043 Enrollment ID: I20201201000870  | 
| Provider Name | Christian Rose | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1194266395 PECOS PAC ID: 3577834878 Enrollment ID: I20210811003479  | 
| Provider Name | Rachide Poteau | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1932778032 PECOS PAC ID: 5395140750 Enrollment ID: I20210823002660  | 
| Provider Name | Kelly Burke | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1346852019 PECOS PAC ID: 6507263266 Enrollment ID: I20210922001902  | 
| Provider Name | Erica Barratt | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1447820246 PECOS PAC ID: 9830596592 Enrollment ID: I20210922002023  | 
| Provider Name | Scott Gestrich | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1558853200 PECOS PAC ID: 8729334586 Enrollment ID: I20210924001550  | 
| Provider Name | Sarah Krueger | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1609503622 PECOS PAC ID: 4385029727 Enrollment ID: I20220921000589  | 
| Provider Name | Abigail Lively | 
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional | 
| Provider Identifiers | NPI Number: 1942931746 PECOS PAC ID: 1456737295 Enrollment ID: I20221003001935  | 
| Provider Name | Nancy Chung | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1689303935 PECOS PAC ID: 8527434166 Enrollment ID: I20221021001850  | 
| Provider Name | Imane Ouahidi | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1548999600 PECOS PAC ID: 0042687477 Enrollment ID: I20221027002478  | 
| Provider Name | Grace Onye | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1336517150 PECOS PAC ID: 1557730637 Enrollment ID: I20221212002622  | 
| Provider Name | Danielle Whitcher | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1114620499 PECOS PAC ID: 9335505395 Enrollment ID: I20230517000278  | 
| Provider Name | Benjamin Strake | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1073004347 PECOS PAC ID: 1759748767 Enrollment ID: I20230607000875  | 
| Provider Name | Brittany Nadeau | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1922425495 PECOS PAC ID: 2961858907 Enrollment ID: I20231026002063  | 
| Provider Name | Tasfia Ahmed | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1184253676 PECOS PAC ID: 5991129744 Enrollment ID: I20231031002437  | 
| Provider Name | Dorothy Savini | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1154038933 PECOS PAC ID: 5092150284 Enrollment ID: I20240227003839  | 
| Provider Name | Kimberly Curtis | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1720866643 PECOS PAC ID: 9931546926 Enrollment ID: I20240326003375  | 
| Provider Name | Kiley Callahan | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1659139814 PECOS PAC ID: 1254773393 Enrollment ID: I20240521003747  | 
| Provider Name | Peter A Cognetti | 
|---|---|
| Provider Type | Practitioner - Sports Medicine | 
| Provider Identifiers | NPI Number: 1154814689 PECOS PAC ID: 5294139952 Enrollment ID: I20240530003597  | 
| Provider Name | Nicole Chaves | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1871015743 PECOS PAC ID: 6305241761 Enrollment ID: I20240923002446  | 
| Provider Name | Samantha Nortelus | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1356176481 PECOS PAC ID: 0547795015 Enrollment ID: I20241120002271  | 
| Provider Name | Nalaya Shand | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1174365829 PECOS PAC ID: 9638604176 Enrollment ID: I20241121000853  | 
| Provider Name | Natalie Fealy | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1043049463 PECOS PAC ID: 8628504446 Enrollment ID: I20241204000064  | 
| Provider Name | Shanell Saunders | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1801618095 PECOS PAC ID: 9032649579 Enrollment ID: I20250212003054  |