| Mattapan Community Health Center Inc | |
|
1575 Blue Hill Ave Boston MA 02126-2122 | |
| (617) 296-0061 | |
| Not Available |
| Full Name | Mattapan Community Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1575 Blue Hill Ave, Boston, Massachusetts |
| Authorized Official Name and Position | Guale Valdez (PRESIDENT & CEO) |
| Authorized Official Contact | 6172960061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mattapan Community Health Center Inc 1575 Blue Hill Ave Boston MA 02126-2122 Ph: () - | Mattapan Community Health Center Inc 1575 Blue Hill Ave Boston MA 02126-2122 Ph: (617) 296-0061 |
| NPI Number | 1942869342 |
|---|---|
| Provider Enumeration Date | 06/10/2019 |
| Last Update Date | 06/10/2019 |
| Medicare PECOS PAC ID | 2062423866 |
|---|---|
| Medicare Enrollment ID | O20190617001304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942869342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Neena Chaturvedi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518091172 PECOS PAC ID: 2860463783 Enrollment ID: I20040804000694 |
| Provider Name | Christopher W Shanahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730184854 PECOS PAC ID: 6901843499 Enrollment ID: I20050415000567 |
| Provider Name | Tarma Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982781977 PECOS PAC ID: 2961430335 Enrollment ID: I20050728000149 |
| Provider Name | Marie O Girault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043379191 PECOS PAC ID: 1456384486 Enrollment ID: I20050912000378 |
| Provider Name | Suzanne E Rocklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679719686 PECOS PAC ID: 9335155597 Enrollment ID: I20060224000227 |
| Provider Name | Margot P Shuman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336183284 PECOS PAC ID: 6204937006 Enrollment ID: I20070724000235 |
| Provider Name | Guirlene Jean-simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326273442 PECOS PAC ID: 1052461126 Enrollment ID: I20090611000083 |
| Provider Name | Alice M O'leary |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225000219 PECOS PAC ID: 8729269196 Enrollment ID: I20110218000565 |
| Provider Name | Nadja St-surin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508062746 PECOS PAC ID: 6305097692 Enrollment ID: I20121114000344 |
| Provider Name | Keona D Lemons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811161458 PECOS PAC ID: 2961643432 Enrollment ID: I20130725000404 |
| Provider Name | Alison Tam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427378777 PECOS PAC ID: 7719119106 Enrollment ID: I20141010000792 |
| Provider Name | Aimee F Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538505771 PECOS PAC ID: 1557593605 Enrollment ID: I20160928000822 |
| Provider Name | Chandler H Christophe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053773515 PECOS PAC ID: 5890080436 Enrollment ID: I20191104002108 |
| Provider Name | Laura Livaditis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811381494 PECOS PAC ID: 3577875459 Enrollment ID: I20200723003076 |
| Provider Name | Alexandra Belcher-obejero-paz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952798704 PECOS PAC ID: 2062727290 Enrollment ID: I20201208000554 |
| Provider Name | Taffidy Joy Berrouette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912344300 PECOS PAC ID: 8527470087 Enrollment ID: I20201208000824 |
| Provider Name | Sarah E. Enteen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821612623 PECOS PAC ID: 3678988938 Enrollment ID: I20210416000651 |
| Provider Name | Howard Lanney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720582406 PECOS PAC ID: 6800146218 Enrollment ID: I20210629002107 |
| Provider Name | Geeth Kavya Minama Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174027171 PECOS PAC ID: 6305182338 Enrollment ID: I20211123000922 |
| Provider Name | Diane Quinones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588148217 PECOS PAC ID: 0345636320 Enrollment ID: I20220330001845 |
| Provider Name | Sophonia Lucien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326390642 PECOS PAC ID: 3476802141 Enrollment ID: I20220507000050 |
| Provider Name | Luca Anna Koritsanszky |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417697442 PECOS PAC ID: 6002295250 Enrollment ID: I20220620000874 |
| Provider Name | Klive M Forde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629331772 PECOS PAC ID: 5496970592 Enrollment ID: I20221005002620 |
| Provider Name | Shauntelle Malcolm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225468804 PECOS PAC ID: 9537535224 Enrollment ID: I20221020002897 |
| Provider Name | Vanessa C Bowen Newton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790853992 PECOS PAC ID: 4486098068 Enrollment ID: I20240222001675 |
| Provider Name | Michael Joseph Kushner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922626282 PECOS PAC ID: 1557706447 Enrollment ID: I20240301001210 |
| Provider Name | Angela Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508434143 PECOS PAC ID: 7517354152 Enrollment ID: I20240501003305 |
| Provider Name | Amanda Reyome |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891043998 PECOS PAC ID: 4385184233 Enrollment ID: I20240906001869 |
| Provider Name | Emily Castellanos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194590117 PECOS PAC ID: 1850831462 Enrollment ID: I20240910003287 |
| Provider Name | Grace Hsieh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154002764 PECOS PAC ID: 4183156201 Enrollment ID: I20241015000619 |
| Provider Name | Abigail Obrien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750015418 PECOS PAC ID: 5597286195 Enrollment ID: I20250312001172 |
Rong J Guan, Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Kneeland St Fl 5, Boston, MA 02111 Phone: 617-290-9881 Fax: 617-350-6555 | |
Robert H. Wu. Md, Pc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Harrison Ave Ste 308, Boston, MA 02111 Phone: 617-338-9889 | |
Boston Health Care For The Homeless Program, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 780 Albany St, Boston, MA 02118 Phone: 857-654-1000 Fax: 857-654-1100 | |
Pratt Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Washington St, Box 1013, Boston, MA 02111 Phone: 617-636-5000 | |
Pjtrains Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 Newbury St Ste 4, Boston, MA 02116 Phone: 857-205-2759 | |
Mhg Physician Services - Michigan Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Harrison Ave, Boston, MA 02118 Phone: 855-340-4663 | |
Boston Food Allergy Center, Steward Healthcare Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 65 Harrison Ave, Suite 201, Boston, MA 02111 Phone: 617-636-8858 Fax: 617-636-8826 |