Codman Square Health Center Inc - Medicare Primary Care in Dorchester Center, MA

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Codman Square Health Center Inc is a medicare enrolled primary clinic (Clinic/center - Community Health) in Dorchester Center, Massachusetts. The current practice location for Codman Square Health Center Inc is 637 Washington St, Dorchester Center, Massachusetts. For appointments, you can reach them via phone at (617) 825-9660. The mailing address for Codman Square Health Center Inc is 637 Washington St, Dorchester, Massachusetts and phone number is (617) 825-9660.

Codman Square Health Center Inc is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1396808309. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (617) 825-9660.

Contact Information

Codman Square Health Center Inc
637 Washington St
Dorchester Center
MA 02124-3510
(617) 825-9660
(617) 288-7898

Map and Direction


Primary Care Clinic Profile

Full NameCodman Square Health Center Inc
SpecialityClinic/Center
Location637 Washington St, Dorchester Center, Massachusetts
Authorized Official Name and PositionGuy Fish (CHIEF EXECUTIVE OFFICER)
Authorized Official Contact6178259660
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Codman Square Health Center Inc
637 Washington St
Dorchester
MA 02124-3510

Ph: (617) 825-9660		Codman Square Health Center Inc
637 Washington St
Dorchester Center
MA 02124-3510

Ph: (617) 825-9660

NPI Details:

NPI Number1396808309
Provider Enumeration Date12/19/2006
Last Update Date03/26/2026
Certification Date03/26/2026

Medicare PECOS Information:

Medicare PECOS PAC ID8123013869
Medicare Enrollment IDO20040420000859

Medical Identifiers

Medical identifiers for Codman Square Health Center Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396808309NPI-NPPES
110022129FMedicaidMA
1211757MedicaidMA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QC1500XClinic/center - Community Health ()Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Codman Square Health Center Inc acts as a billing entity for following providers:
Provider NamePhilip Severin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1689635534
PECOS PAC ID: 5597756007
Enrollment ID: I20040523000002
Provider NameVictoria P Wolfson
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1194759597
PECOS PAC ID: 8022076611
Enrollment ID: I20041229000519
Provider NameStephenson B Tobierre
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1871579342
PECOS PAC ID: 7517913031
Enrollment ID: I20050329000111
Provider NameDonald M Foxworthy
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1558336289
PECOS PAC ID: 2466409073
Enrollment ID: I20050406000298
Provider NameThomas W Barber
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1487627949
PECOS PAC ID: 2567409857
Enrollment ID: I20050408000128
Provider NameSalvatore J Molica
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245393214
PECOS PAC ID: 5597703355
Enrollment ID: I20050421000808
Provider NameVasken M Kroshian
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1225084924
PECOS PAC ID: 6305880659
Enrollment ID: I20050616001090
Provider NameJonathan M Pincus
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1043234099
PECOS PAC ID: 8729015235
Enrollment ID: I20050726000576
Provider NameTrinh Khuu
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1871593871
PECOS PAC ID: 8224069034
Enrollment ID: I20050822000944
Provider NameHyasmine J Verdieu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902929938
PECOS PAC ID: 0840218731
Enrollment ID: I20051109000621
Provider NameIris a Montijo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871754390
PECOS PAC ID: 8123034253
Enrollment ID: I20060228000159
Provider NameChristine a Farrell Riley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1992791883
PECOS PAC ID: 9931208659
Enrollment ID: I20070621000174
Provider NameSharon R Sloan
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1578552014
PECOS PAC ID: 5193812766
Enrollment ID: I20071029000551
Provider NameSara a Tepperberg
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1104816123
PECOS PAC ID: 2961565411
Enrollment ID: I20090110000028
Provider NameThamarah Crevecoeur
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1326284233
PECOS PAC ID: 4789748153
Enrollment ID: I20090129000408
Provider NameZinah S Abukhalil Quinonez
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1376662627
PECOS PAC ID: 4789730631
Enrollment ID: I20090918000229
Provider NameRosha Nicole Forman
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1265683932
PECOS PAC ID: 6204974108
Enrollment ID: I20091113000329
Provider NameTimothy S Naimi
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1679572291
PECOS PAC ID: 1355335290
Enrollment ID: I20100122000120
Provider NameRachel D Hindin
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1134163462
PECOS PAC ID: 9133123565
Enrollment ID: I20110124000315
Provider NameAmanda E Davis
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1295937308
PECOS PAC ID: 2264502905
Enrollment ID: I20110128000627
Provider NameGenevieve C Daftary
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1649439274
PECOS PAC ID: 8022287796
Enrollment ID: I20110815000309
Provider NameCarme D Ogando Saintil
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1316101454
PECOS PAC ID: 9931372471
Enrollment ID: I20111028000601
Provider NameJane F Tuitt
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093879215
PECOS PAC ID: 0345414090
Enrollment ID: I20111116000067
Provider NameStephen M Tringale
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1669536116
PECOS PAC ID: 8022271709
Enrollment ID: I20120516000207
Provider NameFuchsia Y Mitchell
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1922014364
PECOS PAC ID: 3476717216
Enrollment ID: I20120607000412
Provider NameVaishali T Harma
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1750354577
PECOS PAC ID: 5597737056
Enrollment ID: I20120719000267
Provider NameDana Rebecca Mars
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902178585
PECOS PAC ID: 4385806512
Enrollment ID: I20120830000672
Provider NameJustin C Ogbonna
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1952626483
PECOS PAC ID: 7911192471
Enrollment ID: I20121005000002
Provider NameIan D Huntington
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1467680652
PECOS PAC ID: 5193977445
Enrollment ID: I20121212000422
Provider NameSundyna J Beaven
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1134392889
PECOS PAC ID: 0648425918
Enrollment ID: I20130313000213
Provider NameKyla Aprn Biegun
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407191372
PECOS PAC ID: 5193961043
Enrollment ID: I20130419000009
Provider NameTarcia Edmunds-jehu
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1306946942
PECOS PAC ID: 0244453629
Enrollment ID: I20140604000185
Provider NameDebi Sarma
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1164825063
PECOS PAC ID: 4183947294
Enrollment ID: I20141222001510
Provider NameWei M Tseng
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1548527518
PECOS PAC ID: 1052543097
Enrollment ID: I20150930002088
Provider NameEmmanuel Bouloute
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942608674
PECOS PAC ID: 8022326461
Enrollment ID: I20151005000305
Provider NameDavid M Washington
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1851684955
PECOS PAC ID: 9436376837
Enrollment ID: I20160405001612
Provider NameKathleen a Ireland
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1790924249
PECOS PAC ID: 9537254859
Enrollment ID: I20160831000381
Provider NameDarline Joseph
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619244522
PECOS PAC ID: 0042439473
Enrollment ID: I20170113002247
Provider NameJeannie M Baca
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1174872147
PECOS PAC ID: 9739462979
Enrollment ID: I20170213002124
Provider NameSara Stulac
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1407169717
PECOS PAC ID: 7618249400
Enrollment ID: I20170814001454
Provider NameMarie B Federico
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982033288
PECOS PAC ID: 8820343619
Enrollment ID: I20180619002704
Provider NameKelly M Treder
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1235558727
PECOS PAC ID: 7719277565
Enrollment ID: I20180628002053
Provider NameSarah Bozogan Miller
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1235397506
PECOS PAC ID: 8325192552
Enrollment ID: I20190220001922
Provider NameJessica E Isom
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1417334863
PECOS PAC ID: 6305151119
Enrollment ID: I20190903002388
Provider NameTamara Leroy-london
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1427409465
PECOS PAC ID: 9739419599
Enrollment ID: I20190923001069
Provider NameTheresa F Clearman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1144609793
PECOS PAC ID: 7911210174
Enrollment ID: I20191025001169
Provider NameElizabeth M Moran
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205494630
PECOS PAC ID: 3375977366
Enrollment ID: I20191227002316
Provider NameJeremy T NG
Provider TypePractitioner - Sports Medicine
Provider IdentifiersNPI Number: 1407054380
PECOS PAC ID: 6608069950
Enrollment ID: I20200113000274
Provider NameMonique L Anderson-mccurbin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881141836
PECOS PAC ID: 3577846872
Enrollment ID: I20200220001796
Provider NameOnyemaechi Chiekwue Onyekwu
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1164887477
PECOS PAC ID: 5496177404
Enrollment ID: I20200622000130
Provider NameMarta Escriu-sune
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891253795
PECOS PAC ID: 7618395666
Enrollment ID: I20200908003059
Provider NameNnemdi O Azubuko
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689295750
PECOS PAC ID: 0042630253
Enrollment ID: I20201008002474
Provider NameJasmine Welcome
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1457888737
PECOS PAC ID: 9234541491
Enrollment ID: I20201210003111
Provider NameRenee M Crichlow
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1396731832
PECOS PAC ID: 9133110380
Enrollment ID: I20210803003366
Provider NameJennifer J Vanderweele
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1841682127
PECOS PAC ID: 9234489691
Enrollment ID: I20210805003095
Provider NameStephanie E Kuntz
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1689056897
PECOS PAC ID: 0244661528
Enrollment ID: I20210916003123
Provider NameSheri L Kimball
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1639848047
PECOS PAC ID: 6204234263
Enrollment ID: I20211006001875
Provider NameAngela L Mclaughlin
Provider TypePractitioner - Infectious Disease
Provider IdentifiersNPI Number: 1154779932
PECOS PAC ID: 2769777267
Enrollment ID: I20211222001371
Provider NameSamuel D Slavin
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1770003501
PECOS PAC ID: 7214200211
Enrollment ID: I20220210000770
Provider NameSophonia Lucien
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326390642
PECOS PAC ID: 3476802141
Enrollment ID: I20220507000050
Provider NameLuca Anna Koritsanszky
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1417697442
PECOS PAC ID: 6002295250
Enrollment ID: I20220620000874
Provider NameTatiana a Lucien
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477294098
PECOS PAC ID: 9830579432
Enrollment ID: I20220629000165
Provider NameFlorence N Okonkwo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346979721
PECOS PAC ID: 3779950860
Enrollment ID: I20221102001505
Provider NameDan Phuong T Nguyen
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1245692722
PECOS PAC ID: 2961872429
Enrollment ID: I20221228001893
Provider NameHilda Awuah-antwi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043882913
PECOS PAC ID: 0143691469
Enrollment ID: I20230125000865
Provider NameGabriella M Woeste
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1447712229
PECOS PAC ID: 5698181634
Enrollment ID: I20230328000391
Provider NameSam C Gonzalez
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1881199560
PECOS PAC ID: 1456600782
Enrollment ID: I20230705001910
Provider NameThatiana Jeune
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417520636
PECOS PAC ID: 1557724242
Enrollment ID: I20230829000558
Provider NameCathyana Jean-baptiste
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689362683
PECOS PAC ID: 6800259516
Enrollment ID: I20230829001737
Provider NameAnh V Bui
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1891363644
PECOS PAC ID: 3476930454
Enrollment ID: I20230830002958
Provider NameJustin Michael Carrion
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1487388161
PECOS PAC ID: 1355705450
Enrollment ID: I20230907002755
Provider NameKimberly Thien Truong
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1962284497
PECOS PAC ID: 6608228622
Enrollment ID: I20240116001033
Provider NameJessica Pierre Francois
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1285262089
PECOS PAC ID: 9739522020
Enrollment ID: I20240202002619
Provider NameRuth Manu
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1669099503
PECOS PAC ID: 0941647820
Enrollment ID: I20240327002583
Provider NameRegine Kersaint
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1487230652
PECOS PAC ID: 5496194433
Enrollment ID: I20240423003694
Provider NameTamika Y Wisdom
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275887101
PECOS PAC ID: 7214470996
Enrollment ID: I20240622000097
Provider NameMeygan J Lackey
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1396326500
PECOS PAC ID: 3173992492
Enrollment ID: I20240819004053
Provider NameShannon M Lyons
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033968003
PECOS PAC ID: 8325589427
Enrollment ID: I20240917000855
Provider NameKathleen Lapommeray
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1427896919
PECOS PAC ID: 4981135167
Enrollment ID: I20240927002620
Provider NameRayyan M Quip
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1366068165
PECOS PAC ID: 3072930221
Enrollment ID: I20241101002645
Provider NameHector R. Nunez Jorge
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1982319497
PECOS PAC ID: 9032557970
Enrollment ID: I20241121002917
Provider NameAmrutha Denduluri
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1174290951
PECOS PAC ID: 0042609471
Enrollment ID: I20241122002357
Provider NameNaomi E Goodman
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1821817412
PECOS PAC ID: 6002342672
Enrollment ID: I20241205002486
Provider NameSonja Louise Edwards-sylvester
Provider TypePractitioner - Mental Health Counselor
Provider IdentifiersNPI Number: 1972094571
PECOS PAC ID: 9739619552
Enrollment ID: I20250210001408
Provider NameAshley M Wilhelm
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1174902092
PECOS PAC ID: 3375846728
Enrollment ID: I20250428000496
Provider NameAwah-lem Atanga Mccormick
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1699395004
PECOS PAC ID: 3072996552
Enrollment ID: I20250708000844
Provider NameJulia E Gaughan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942886338
PECOS PAC ID: 1658870324
Enrollment ID: I20250819002653
Provider NameJennifer E Bugos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972393049
PECOS PAC ID: 2365944402
Enrollment ID: I20250908000779
Provider NameMeghna Nandi
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1881271476
PECOS PAC ID: 0244629624
Enrollment ID: I20250911001951

Reviews and Comments

Other Primary Care Clinics in Dorchester Center, MA

Thomas J Kenney MD Inc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 2110 Dorchester Ave, Suite 210, Dorchester Center, MA 02124
Phone: 617-296-9510    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.