| Greater Roslindale Medical And Dental Center | |
|
4199 Washington St Roslindale MA 02131-1733 | |
| (617) 323-4440 | |
| (617) 323-7870 |
| Full Name | Greater Roslindale Medical And Dental Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4199 Washington St, Roslindale, Massachusetts |
| Authorized Official Name and Position | Teresa T Newsom (SVP, CFO) |
| Authorized Official Contact | 6174142693 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Roslindale Medical And Dental Center 4199 Washington St Roslindale MA 02131-1733 Ph: (617) 323-4440 | Greater Roslindale Medical And Dental Center 4199 Washington St Roslindale MA 02131-1733 Ph: (617) 323-4440 |
| NPI Number | 1386718823 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 07/12/2023 |
| Medicare PECOS PAC ID | 0547222051 |
|---|---|
| Medicare Enrollment ID | O20050531000034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386718823 | NPI | - | NPPES |
| 1212095 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | V112 (Massachusetts) | Primary |
| Provider Name | Tu Mai Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740338524 PECOS PAC ID: 9638075484 Enrollment ID: I20031211000337 |
| Provider Name | Deepa Jhaveri |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1477549350 PECOS PAC ID: 2769471259 Enrollment ID: I20040510001065 |
| Provider Name | Charles T Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134107436 PECOS PAC ID: 4183614654 Enrollment ID: I20040517000162 |
| Provider Name | Mari J Bentley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043299027 PECOS PAC ID: 2860476629 Enrollment ID: I20040617001035 |
| Provider Name | Norman Alan Wortzman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1770560054 PECOS PAC ID: 5890769913 Enrollment ID: I20040824001097 |
| Provider Name | Carol A Oneil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316935729 PECOS PAC ID: 0547206294 Enrollment ID: I20050701000861 |
| Provider Name | Ilia J Coka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083693386 PECOS PAC ID: 8628098290 Enrollment ID: I20051128000505 |
| Provider Name | John L Sherman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467458737 PECOS PAC ID: 3173532595 Enrollment ID: I20060413000077 |
| Provider Name | Katherine A Gergen Barnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023209129 PECOS PAC ID: 7618036047 Enrollment ID: I20081030000230 |
| 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 | Anne Ollen-smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255482998 PECOS PAC ID: 3375684954 Enrollment ID: I20100105000038 |
| Provider Name | Janet Susan Protiva |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639158926 PECOS PAC ID: 7315062809 Enrollment ID: I20100921001067 |
| Provider Name | Theresa O. Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427037720 PECOS PAC ID: 1456536762 Enrollment ID: I20110502000715 |
| Provider Name | Aileen M Richmond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760619928 PECOS PAC ID: 1355593070 Enrollment ID: I20121204000151 |
| Provider Name | Amola Shertukde Bhakta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346560901 PECOS PAC ID: 1456594142 Enrollment ID: I20130828000350 |
| Provider Name | Jordana W Price |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770746653 PECOS PAC ID: 0042472391 Enrollment ID: I20140806000068 |
| Provider Name | Afi Mansa Semenya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861786972 PECOS PAC ID: 0143542233 Enrollment ID: I20141126001382 |
| Provider Name | Marissa R Hamrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386905685 PECOS PAC ID: 9335371426 Enrollment ID: I20150922003338 |
| Provider Name | Jennifer L Trieu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992026777 PECOS PAC ID: 3173764271 Enrollment ID: I20151117000145 |
| Provider Name | Lisa M Harrington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740637701 PECOS PAC ID: 1153602891 Enrollment ID: I20170111002279 |
| Provider Name | Rachel Cannon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407198617 PECOS PAC ID: 0941509269 Enrollment ID: I20170522002611 |
| Provider Name | Mary Ann Dakkak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326313776 PECOS PAC ID: 2668605296 Enrollment ID: I20171017003600 |
| Provider Name | Rebecca D Dallman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578862702 PECOS PAC ID: 6608008685 Enrollment ID: I20171025003208 |
| Provider Name | Juliana I Castedo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992191167 PECOS PAC ID: 3971818451 Enrollment ID: I20180831000310 |
| Provider Name | Stephen M. Marsh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528453008 PECOS PAC ID: 0446565394 Enrollment ID: I20190423000207 |
| Provider Name | Matthew Maurice Eckstat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437549763 PECOS PAC ID: 2163717711 Enrollment ID: I20190806001611 |
| Provider Name | Brian T Kroener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205220126 PECOS PAC ID: 0840503850 Enrollment ID: I20191030002935 |
| Provider Name | Keyse Angelo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114474772 PECOS PAC ID: 5092128660 Enrollment ID: I20201229001779 |
| Provider Name | Brenda F Levy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053639765 PECOS PAC ID: 2961633300 Enrollment ID: I20210526001088 |
| Provider Name | Alison Presti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366946071 PECOS PAC ID: 4587914932 Enrollment ID: I20210723003053 |
| Provider Name | Julian Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861996134 PECOS PAC ID: 4082964531 Enrollment ID: I20210823000850 |
| Provider Name | Julia M Kirchner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962907568 PECOS PAC ID: 4587066188 Enrollment ID: I20221108001225 |
| Provider Name | Jayme Mendelsohn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770043374 PECOS PAC ID: 6507291705 Enrollment ID: I20221108002588 |
| Provider Name | Ryan J Narciso |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1093275273 PECOS PAC ID: 5597099317 Enrollment ID: I20230614003671 |
| Provider Name | Camille Nakita Rivers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053948927 PECOS PAC ID: 7911318704 Enrollment ID: I20230911002796 |
| Provider Name | Lily Ann Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609495514 PECOS PAC ID: 7810319621 Enrollment ID: I20231020001509 |
| Provider Name | Anne M Munroe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902018740 PECOS PAC ID: 9335681220 Enrollment ID: I20240606002856 |
Mendes Medical Assoc. Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 55 Belgade Ave, Roslindale, MA 02131 Phone: 617-327-7465 Fax: 617-363-9993 | |
Greater Roslindale Medical And Dental Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4199 Washington St, Roslindale, MA 02131 Phone: 617-323-4440 Fax: 617-323-7870 | |
Hebrew Seniorlife Affiliated Medical Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 Centre St, Roslindale, MA 02131 Phone: 617-971-5766 Fax: 617-363-8913 | |
Melissa Landry Nutrition Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 37 Fairview St # 1, Roslindale, MA 02131 Phone: 617-842-4118 |