NPIMap

Organization Active NPI

Codman Square Health Center

  • Community Health Clinic/Center
  • Randolph, MA
National Provider Identifier
1003770736
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CODMAN SQUARE HEALTH CENTER
Practice address
42 Highland Avenue
Randolph, MA 02368-0000
Phone
(617) 825-9660
Fax
(617) 288-7898
NPI assigned
Dec 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Guy Fish
Title
Ceo
Phone
(617) 825-9660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

42 Highland Avenue
Randolph, MA 02368-0000

Mailing address

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

National Provider Directory

National Provider Directory
Tax ID family
Codman Square Health Ce4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

42 Highland Ave
Randolph, MA 02368
Phone (617) 825-9660

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1003770736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 HIGHLAND AVENUE",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023680000",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CODMAN SQUARE HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-15",
        "status": "A",
        "authorized_official_last_name": "FISH",
        "authorized_official_first_name": "GUY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-825-9660"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.