| Fqhc Facility | |
|
1575 Blue Hill Ave Mattapan MA 02126-2122 | |
| (617) 296-0061 | |
| (617) 296-5408 |
| Full Name | Fqhc Facility |
|---|---|
| Speciality | Clinic/Center |
| Location | 1575 Blue Hill Ave, Mattapan, Massachusetts |
| Authorized Official Name and Position | Guale Valdez (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6178989090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fqhc Facility 1575 Blue Hill Ave Mattapan MA 02126-2122 Ph: (617) 296-0061 | Fqhc Facility 1575 Blue Hill Ave Mattapan MA 02126-2122 Ph: (617) 296-0061 |
| NPI Number | 1639240393 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 04/29/2019 |
| Medicare PECOS PAC ID | 2062423866 |
|---|---|
| Medicare Enrollment ID | O20130313000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639240393 | NPI | - | NPPES |
| 1301438 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Howard Lanney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720582406 PECOS PAC ID: 6800146218 Enrollment ID: I20210629002107 |
Barnett Medical Associates,pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 745 River St, Mattapan, MA 02126 Phone: 617-364-0222 Fax: 617-364-3470 | |
Mattapan Medical Associates Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1537 Blue Hill Ave, Mattapan, MA 02126 Phone: 617-296-3500 Fax: 617-296-5608 | |
Elder Service Plan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 Morton Street, Mattapan, MA 02126 Phone: 617-533-2400 Fax: 617-533-2401 | |
Advanced Chiropractic Therapy Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1651 Blue Hill Ave, 2nd Floor, Mattapan, MA 02126 Phone: 617-296-3951 Fax: 617-296-1036 | |
Hyde Park Health Associates Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 745 River St, Mattapan, MA 02126 Phone: 617-364-2588 | |
Harbor Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 Morton Street, Mattapan, MA 02126 Phone: 617-533-2300 Fax: 617-533-2301 |