| South End Community Health Center Inc | |
|
1601 Washington St Boston MA 02118-1951 | |
| (617) 425-2000 | |
| (617) 424-8725 |
| Full Name | South End Community Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1601 Washington St, Boston, Massachusetts |
| Authorized Official Name and Position | William Walczak (CEO) |
| Authorized Official Contact | 6174252000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South End Community Health Center Inc 1601 Washington St Boston MA 02118-1951 Ph: (617) 425-2000 | South End Community Health Center Inc 1601 Washington St Boston MA 02118-1951 Ph: (617) 425-2000 |
| NPI Number | 1619927233 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 04/29/2019 |
| Medicare PECOS PAC ID | 9537063722 |
|---|---|
| Medicare Enrollment ID | O20031121000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619927233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Deborah J Sheldon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457312613 PECOS PAC ID: 4880589571 Enrollment ID: I20040220000526 |
| Provider Name | Sandra Felder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164583548 PECOS PAC ID: 1557320801 Enrollment ID: I20041004000689 |
| Provider Name | Glennon J O Grady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174502140 PECOS PAC ID: 0042282378 Enrollment ID: I20041207000246 |
| Provider Name | David K Urion |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497778195 PECOS PAC ID: 6709832306 Enrollment ID: I20050328000256 |
| Provider Name | Raymond Walden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568514081 PECOS PAC ID: 0143258129 Enrollment ID: I20050801000425 |
| Provider Name | Nelson E Ochoa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760534366 PECOS PAC ID: 5193758399 Enrollment ID: I20050917000328 |
| Provider Name | Oscar Soto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083865257 PECOS PAC ID: 6103980180 Enrollment ID: I20090206000097 |
| Provider Name | Lilia H Cardenas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841406964 PECOS PAC ID: 7113063868 Enrollment ID: I20091009000269 |
| Provider Name | Corinne M Prigo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023331741 PECOS PAC ID: 7517095003 Enrollment ID: I20100504000142 |
| Provider Name | Kathryn E Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114248408 PECOS PAC ID: 0547454431 Enrollment ID: I20101104001023 |
| Provider Name | Amanda E Davis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1295937308 PECOS PAC ID: 2264502905 Enrollment ID: I20110128000627 |
| Provider Name | Karen J Shaw |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1619913332 PECOS PAC ID: 5597934109 Enrollment ID: I20110816000032 |
| Provider Name | Rachel B. King |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831353945 PECOS PAC ID: 8729259643 Enrollment ID: I20110924000004 |
| Provider Name | Kristen H Behrens |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730434754 PECOS PAC ID: 8921250036 Enrollment ID: I20121218000034 |
| Provider Name | Laurie Goldman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780736272 PECOS PAC ID: 0042457426 Enrollment ID: I20130501000514 |
| Provider Name | Richard C Villa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467734962 PECOS PAC ID: 3375762479 Enrollment ID: I20140923001629 |
| Provider Name | Megan L Evans |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871888172 PECOS PAC ID: 3870806797 Enrollment ID: I20150722003563 |
| Provider Name | Lindsay C Corse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639438476 PECOS PAC ID: 4385876614 Enrollment ID: I20151007002073 |
| Provider Name | Kathryn M Levasseur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811364953 PECOS PAC ID: 6507169737 Enrollment ID: I20160122000143 |
| Provider Name | Nichole T Daly |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1043674484 PECOS PAC ID: 8628368628 Enrollment ID: I20160603000460 |
| Provider Name | Jonathan S Abrams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285916007 PECOS PAC ID: 7618267618 Enrollment ID: I20160603000515 |
| Provider Name | Lauren E. Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194179234 PECOS PAC ID: 8628364957 Enrollment ID: I20160912002498 |
| Provider Name | Vanessa Louise Loukas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598113359 PECOS PAC ID: 1850679085 Enrollment ID: I20161024000325 |
| Provider Name | Mekkin E Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245674985 PECOS PAC ID: 4688952781 Enrollment ID: I20161025000315 |
| Provider Name | Elizabeth W Patton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053647230 PECOS PAC ID: 6800020520 Enrollment ID: I20170124000023 |
| Provider Name | Maya Mauch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093129488 PECOS PAC ID: 7810282183 Enrollment ID: I20170925001893 |
| Provider Name | Rachel N Berkowitz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417332214 PECOS PAC ID: 6204125180 Enrollment ID: I20180201000948 |
| Provider Name | Deanne Dworski-riggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093114332 PECOS PAC ID: 1850652165 Enrollment ID: I20180301001729 |
| Provider Name | T.lee Shostack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013298827 PECOS PAC ID: 4880956325 Enrollment ID: I20180322000436 |
| Provider Name | Jessica L Lebow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659895647 PECOS PAC ID: 2567727241 Enrollment ID: I20180530000917 |
| Provider Name | Keila Casillas Claudio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679851711 PECOS PAC ID: 4789855784 Enrollment ID: I20181008001071 |
| Provider Name | Felix Trede |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174958243 PECOS PAC ID: 4880934892 Enrollment ID: I20190328001363 |
| Provider Name | Alexandra S Rautiola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649704800 PECOS PAC ID: 9234471608 Enrollment ID: I20190506000376 |
| Provider Name | Brian Paul Jewers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841799046 PECOS PAC ID: 2769724152 Enrollment ID: I20190506000877 |
| Provider Name | Sibyl Lynn Salisbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609009893 PECOS PAC ID: 5698093888 Enrollment ID: I20191021002550 |
| Provider Name | Kareena A Richards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588140925 PECOS PAC ID: 0042542623 Enrollment ID: I20191031001342 |
| Provider Name | Lauren M Ciszak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437563723 PECOS PAC ID: 2769787076 Enrollment ID: I20200219002599 |
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 | |
Fenway Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1340 Boylston St, Boston, MA 02215 Phone: 617-927-4880 | |
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 | |
Barbara Mcinnis House 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 - Gastroenterology 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 |