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. |
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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 |
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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 |
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Provider Enumeration Date | 09/25/2006 |
Last Update Date | 03/03/2023 |
Certification Date | 03/03/2023 |
Medicare PECOS PAC ID | 4486555158 |
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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 | Jacalyn Newman |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1578628566 PECOS PAC ID: 5193753101 Enrollment ID: I20050801000632 |
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 | 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 Spain |
---|---|
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 | Abigail Granigan |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1760969091 PECOS PAC ID: 0244646834 Enrollment ID: I20210305000722 |
Provider Name | Christian Rose |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194266395 PECOS PAC ID: 3577834878 Enrollment ID: I20210811003479 |
Provider Name | Nicole Colageo |
---|---|
Provider Type | Practitioner - Other (non-physician) |
Provider Identifiers | NPI Number: 1871015743 PECOS PAC ID: 6305241761 Enrollment ID: I20210823002621 |
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 | Marissa Abdow |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1548894934 PECOS PAC ID: 8123437563 Enrollment ID: I20220919001631 |
Provider Name | Sarah Raphaelson |
---|---|
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 |